To analyze the epidemiological characteristics and spatiotemporal distribution of sexually transmitted infections (STIs) including HIV/AIDS, gonorrhea and syphilis in China from 2010 to 2020, providing scientific evidence for optimizing STIs prevention and control strategies.

Case data on STIs (HIV/AIDS, gonorrhea, syphilis) from 2010 to 2020 were extracted from the Public Health Data Center. Descriptive epidemiology, standard deviation ellipse, center of gravity migration modeling, and spatial autocorrelation analysis were employed to analyze epidemiological characteristics and spatial evolution patterns.

From 2010 to 2020, a cumulative total of 6 558 885 HIV/AIDS, gonorrhea and syphilis cases were reported across 31 provinces nationwide, with an average annual incidence rate of 43.55 per 100 000 population. Syphilis accounted for the highest proportion (73.68%), followed by gonorrhea (18.31%) and AIDS (8.01%). The incidence of AIDS continued to rise (1.20 → 4.43 per 100 000), syphilis fluctuated upward (26.86 → 33.08 per 100 000), while gonorrhea slightly decreased (7.91 → 7.49 per 100 000). Gonorrhea exhibited seasonal peaks in summer and autumn (July-October), whereas other STIs showed no distinct seasonal patterns. The primary high-risk group for AIDS was individuals aged 20 and above, while gonorrhea predominantly affected those aged 15-25. The high-risk group for syphilis shifted from infants and young children to individuals aged 85 and above. HIV/AIDS clustered in the southwest region and spread toward the northwest. Gonorrhea was prevalent in eastern regions (Zhejiang, Fujian) and southern China (Guangdong, Hainan). Syphilis originated in southern China (Guangdong, Guangxi Zhuang Autonomous Region) and spread toward the northwest (Qinghai, Xinjiang Uygur Autonomous Region). Global spatial autocorrelation analysis revealed significant positive spatial correlations between HIV/AIDS (except in 2010) and gonorrhea incidence, with increasing clustering intensity annually (Moran's I values: 0.08-0.36, P<0.05). Syphilis incidence primarily exhibited random distribution patterns (Moran's I values: 0.06-0.34, P>0.05). Standard deviation ellipses and center of gravity migration models revealed that the epidemic center was located at the junction of Sichuan, Chongqing, and Hunan provinces. From 2010 to 2020, the center first shifted northward and then southward, with the greatest displacement occurring in 2012 and 2019—2020.

STIs in China from 2010 to 2020 exhibited distinct spatio-temporal clustering. Given the substantial burden of sexually transmitted infections in China and the persistent southward shift of hotspots, differentiated interventions should be implemented in high-incidence areas and key populations across Southwest and South China. Strengthening cross-regional joint prevention and control mechanisms is imperative.