Objective To investigate the characteristics and trends in the HIV epidemic in Yunnan province, China between 1989 and 2007.

Methods Statistical analysis of serological data from voluntary testing and counselling sites, medical case reports, mass screenings, sentinel surveillance, and other sources.

Results By 2007, a cumulative total of 57 325 cases of HIV infection had been detected in Yunnan, and unsafe drug injection practices and unsafe sexual behaviours were identified as the dominant modes of transmission. Analysis shows HIV is spreading among IDUs, particularly among the Jingpo, Dai and Yi ethnicities, as well as among MSM and FSWs, some of whom also inject drugs. Rising numbers of reported HIV among male clients of FSWs (1.8%), STD clinic patients (2.1%), pregnant women (0.50%), and blood donors (0.084%) suggest infection in the general population is underway.

Conclusion The HIV epidemic in Yunnan has progressed to a concentrated epidemic. Future efforts must focus on not only on groups at risk for primary infection (IDUs, MSM, FSWs) but also on their lower-risk sexual partners. Future policy must improve efficacy and coverage of programs specifically targeting ethnic minorities, IDUs, MSM, and FSWs, particularly those who inject drugs or work at the street-level.