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Macao became a special administrative region of China as of December 1999. It is located
on the southern coast of China to the west of the Pearl River Delta . It comprises the
peninsula of Macao and the two islands of Taipa and Coloane, with a total land area of 23.8
km2. As of 31 December 2000, Macao’s local population numbered 438 000 inhabitants.
Population density is over 18 000/km2,, with the northern part of the peninsula of Macao
considered one of the most densely populated areas in the world. Macao’s economy has
been experiencing rapid growth since the 1980s. Public health care in Macao is comparable
with that of developed countries. The average life span for both sexes is over 75 years old.
In Macao, the first HIV infection was reported in 1986 and the first case of AIDS in 1989.
The Department of Health of Macao has, since 1986, been conducting several surveillance
activities. The different approaches used include, among others: an unlinked and anonymous
serosurveillance that includes outpatients more than 15 years old and pregnant women
attending antenatal consultations as target populations; and HIV screening for selected
groups, such as blood donors, tuberculosis patients, prisoners, injecting drug users (IDU)
referred by NGOs, and entertainment workers. Since 1986 until the end of December
2000, 230 HIV infections had been reported, 70.9% diagnosed in temporary residents
working in the entertainment industry. The HIV transmission in Macao is essentially
sexual: the most important route of transmission has been heterosexual (71.7%). A large
proportion of HIV cases have been found among women, transmitted through heterosexual
contact, representing 67.8% of all new cases (female to male ratio: 2.1 to 1). If the
temporary residents working in the entertainment industry are excluded from the data, the
cumulative number of HIV cases from 1986 until the end of December 2000 is 67, and the
pattern profile of HIV infection in Macao becomes different: men are responsible for
68.7% of all new HIV cases (male to female ratio: 2.3 to 1) and for 81.0% of AIDS cases;
the principal route of transmission is heterosexual, with a percentage of 35.8%; injecting
drug use transmission accounts for 14.9% of infections; and the homosexual route for
13.4%. Among the 67 HIV cases detected in the Macao resident population, 21 (31.3%)
have progressed to AIDS. No estimation of HIV/AIDS was developed for Macao.
The data obtained show that the HIV spread among Macao’s general population has been
very limited, despite the tendency for increase among some high -risk behaviour groups,
such as IDUs. Surveillance of antenatal clinic attendees in Macao, has shown that HIV
prevalence is still low in that group.
Since the mid-1990s, Macao has been able to provide treatment to HIV-infected residents.
However, many of HIV-infected persons have been first detected after the onset of AIDS
defining conditions. The number of newly reported AIDS cases in Macao has been, since
the mid-1990s, about 2 to 4 per year.