Analysis of late diagnosis trends of HIV cases reported by VCT clinics in China,2015-2022
Objective To understand the trends of late diagnosis among new HIV cases reported by voluntary counselling and testing(VCT)clinics in China between 2015 and 2022.Methods Data on new HIV cases reported by VCT clinics during the period was extracted from the HIV/AIDS Comprehensive Response Information Management System.Using the Joinpoint regression model,the annual percent change(APC)and average annual percent change(AAPC)in the proportion of late diagnosis were calculated,and a time trend analysis was conducted.The age-standardized proportion of late diagnosis(ASPLD)was calculated for various populations using the age distribution of VCT-reported cases from 2015 to 2022 as the standard.Results A total of 256 098 adult HIV cases were reported by VCT clinics from 2015 to 2022.While the number of cases initially increased until 2019,and it started declining thereafter.Overall,the proportion of late diagnosis among these cases was 58.18％(149 019/256 098),exhibiting a statistically significant upward trend overall(AAPC=1.6％,95％CI:1.2％-2.0％,P＜0.05).Notably,the proportion of late diagnosis increased with age.The highest proportion of 72.59％was observed among cases aged 60 years and older,but with no significant trend(P＞0.05).Conversely,the fastest rate of increase(AAPC=2.5％,95％CI:1.7％-3.2％,P＜0.05)was seen in the 18-24 age group,with a late diagnosis proportion of 44.04％.Among sexually transmitted cases,the ASPLD was higher for males(60.09％)compared to females(55.11％).While the latter group showed a rising trend(AAPC=0.9％,95％CI:0.1％-2.6％,P＜0.05).Conclusions Among new HIV cases reported by VCT clinics in China,late diagnosis was conccrningly prevalent in males aged 60 and older and in those infected through heterosexual transmission,particularly females,where the proportion continues to rise.This highlights the need for reinforced HIV testing strategies,targeted AIDS education campaigns and specific testing initiatives for the elderly,as well as strengthened testing and publicity aimed at female population,to effectively address the persistent challenge of late diagnosis in China's HIV prevention and control efforts.
HIV/AIDSvoluntary counselling and testing(VCT)infection statuslate diagnosis
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NSTL
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