Demographic Shifts and the Spread of HIV in China

Sara Hertog, University of Wisconsin at Madison
Giovanna Merli, University of Wisconsin at Madison

Much speculation exists as to the role that China’s changing demography will play in contributing to the spread of HIV/AIDS. We employ a bio-behavioral macrosimulation model to assess the potential HIV epidemic impact of two important demographic shifts currently underway in China: (1) the imbalanced sex ratios that alter the market for sexual partners; and (2) the swells in labor migration from the countryside to China’s urban centers that accompany rapid socioeconomic transformation. Simulated scenarios are informed by the available evidence linking masculine sex ratios and migration to shifts in patterns of sexual partnering in both historical and contemporary societies. Results illustrate the influence of similar shifts in sexual behavior on the heterosexual spread of HIV within the context of China’s present and projected imbalanced sex ratios and migration flows between rural and urban areas.