Objective  To analyze spatial distribution and clustering characteristics of AIDS incidence in 31 provinces, municipalities and autonomous regions in China from 2005 to 2017, and to provide evidences for formulating regional AIDS prevention and control measures and rationally allocating the prevention and control resources.

  Methods  Data on AIDS incidence between 2005 and 2017 across China were extracted from China Health Statistical Yearbook, China Health and Family Planning Statistical Yearbook and China Health Statistical Yearbook. Chi-square test for trend and hierarchical map were used to display the epidemic trend and spatial distribution of AIDS incidence. Global and local spatial autocorrelation were used to identify the spatial correlation and spatial clustering features of AIDS incidence.

  Results  From 2005 to 2017, the incidence of AIDS in China exhibited a increasing trend generally, with a regional distribution of being higher in Western and Southern China and lower in Eastern and Northern China. High-incidence areas were mainly observed in southwest regions and Xinjiang Uygur Autonomous Region, and are gradually spreading from the South to the North and from the West to the East. The global Moran′s I value increased from 0.022 to 0.386, indicating that AIDS incidence was significantly and positively auto-correlated and there was a increasing trend for the spatial correlation. Local spatial autocorrelation analyses showed that there was a high-low cluster of AIDS incidence only in Guangxi Zhuang Autonomous Region and Henan province in 2005; from 2008 to 2011, a high-high cluster in Guangxi Zhuang Autonomous Region and Yunnan province appeared; between 2014 and 2017, high-high clusters were identified in Guangxi Zhuang Autonomous Region and Yunnan, Sichuan, Guizhou province and Chongqing municipality.

  Conclusion  As the incidence of AIDS is continuously rising in China, the features of positive spatial correlation and spatial cluster become more obvious, and the high-high clusters of AIDS incidence are regionally expanding. Therefore, the prevention and control of AIDS incidence should focus on high incidence regions and its surroundings.