Before 2009, most HIV infections in China were caused by intravenous drug use, blood transfusions, mother-to-child transmission and “unknown” factors. Now sexual transmission accounts for more than 92 percent of all new infections.

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As China observes World AIDS Day on Tuesday, health officials and researchers are raising alarms over an increase in new infections among high-school and college students. Most are young men who have had unprotected sex with other men, Wu Zunyou, director of the National Center for AIDS and Sexually Transmitted Disease Control and Prevention, told China Daily.

As of October, China had about 575,000 people living with HIV/AIDS, according to Chen Zhongdan, a Chinese adviser to UNAIDS, the United Nations’ AIDS-fighting agency. Before 2009, most reported HIV infections in China were caused not by sex but by intravenous drug use, blood transfusions, mother-to-child transmission and “unknown” factors, according to the figures from the Chinese Center for Disease Control and Prevention.

But now sexual transmission accounts for more than 92 percent of all new infections. (By the end of 2014, nearly 39 million people were living with HIV/AIDS worldwide, according to UNAIDS.)

From 1985 to 2005, the statistics showed, about 30 percent of HIV infections in China were caused by the blood trade, which was often supported by local officials. A common practice was to extract plasma from the blood, which was then pooled and reinjected into blood sellers so they could give more often. The sharing of needles in intravenous drug use was also a major route of infection.

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The state has been effective at containing those two problems, said Jing Jun, the director of the Center for Research on Public Health at Tsinghua University.

“But the government seems much less effective in controlling the private sphere of ordinary people’s lives, as evidenced by the rapid increase of HIV infections via heterosexual and homosexual routes,” he said.

From 1985 to 2005, just 0.3 percent of reported new infections occurred among men having sex with men. By the end of June 2015, that had risen to more than 27 percent, the statistics showed.

Male high-school and college students ages 15 to 24 are an emerging high-risk group, according to Wang Ning, an AIDS specialist at the Chinese Center for Disease Control and Prevention.

“Before, large numbers of infected people were from not-too-developed regions,” Wang told The Beijing News. “Now it has entered cities and universities where the so-called elite groups are. Even though this special group has the information to prevent AIDS, when they indulge in high-risk behavior, they don’t use their knowledge to protect themselves.”

Wu, of the National Center for AIDS and Sexually Transmitted Disease Control and Prevention, said more than 3,400 cases had been reported among students so far this year, compared with 779 in 2008, China Daily reported. Nearly 81 percent contracted HIV through gay sex, he said.

Another factor is that sex education is still rare in China. Another risk factor, Chen said, is the common practice in China of gay men marrying women to avoid social stigma and to produce offspring as a filial gesture toward parents.

Dating apps have also contributed to the rising number of sexually transmitted cases among gay men, Chen said.