The International Symposium on the Prevention and Control of HIV in China was held in Beijing, China, on 13 and 14 November to discuss China’s evolving HIV epidemic. The symposium was sponsored by China’s National Health and Family Planning Commission and the Ministry of Science and Technology, with the support of UNAIDS, the World Health Organization and the United States Centers for Disease Control and Prevention.

The meeting aimed to put forward new strategies for preventing HIV through sexual transmission. Wang Guoqiang, Vice-Minister of the Chinese National Health and Family Planning Commission, opened the meeting by underlining China’s commitment to HIV prevention. Luiz Loures, UNAIDS Deputy Executive Director, commended China for its political commitment to the HIV response and for innovations that include a unique platform for financing civil society organizations to support prevention efforts.

In the early 2000s, people who inject drugs were at the highest risk of HIV in the country, but a harm reduction programme that started in 2006 rapidly expanded opioid substitution therapy. According to the Chinese National Center for AIDS/STD Control and Prevention, China’s free and voluntary opioid substitution therapy programme is now the largest in the world, cumulatively serving about half a million people over the past 10 years. Government data show that HIV prevalence among people who inject drugs has declined to an estimated 6% in 2015 from more than 12% in 2005.

Public health data from China suggest that gay men and other men who have sex with men are emerging as the group most affected by HIV. According to government data, less than half of gay men and other men who have sex with men know their HIV status and consistent condom use in the past six months has remained at around 45% for a number of years. One innovation has been the active role of community-based organizations, which have actively provided services to their peers with the support of local hospitals. However, other interventions that studies have found to be effective, such as the use of self-testing and pre-exposure prophylaxis, are still at the research stage in China.

The participants of the symposium presented the Chinese government with preliminary recommendations on how to strengthen HIV prevention and control in China, which include shifting the focus to a stratified 90–90–90 target. The recommendations also include increasing resources to community groups and moving forward more aggressively beyond effectiveness and efficacy studies to large implementation and cost-effectiveness studies. Removing institutionalized stigma and discrimination, particularly in health-care settings, was emphasized as a vital component of success.