Epidemiological characteristics of HIV/AIDS patients aged 60 years and above at diagnosis in Fujian province: a retrospective analysis

  Objective  To analyze epidemiological characteristics of human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) patients aged 60 years and above at their diagnosis in Fujian province, and to provide evidences for specific intervention on the patients and reasonable allocation of healthcare resources.

  Methods  From all HIV/AIDS patients registered in Fujian province between January 2015 through December 2019, we enrolled 2 152 older cases (aged 60 years and above at their diagnoses) and conducted a retrospective survey to collect the cases′ information on demographics, risk behavior history, probable transmission route, and HIV antibody and CD₄ ⁺T lymphocyte cell count detection. Descriptive statistics was performed to analyze epidemiological characteristics of the older HIV/AIDS cases.

  Results  For the reported older HIV/AIDS patients, the annual number increased and so did its proportion against the total number of patients during 2015 – 2019 (χ² = 90.411, P < 0.001). The most of the older cases (91.6%, 1 971/2 152）were infected through heterosexual transmission, but the ways of heterosexual transmission were significantly different between the male and female cases. For the cases infected through heterosexual transmission, the majority (67.9%, 1 079/1 589）of the males were infected through commercial sex, while the females were mainly through noncommercial and extramarital sex (44.2%, 169/382) and marital sex (39.5%, 151/382). In the older cases, the proportion of the infection through extramarital and noncommercial sex and marital sex decreased, but that of through commercial sex increased; compared to those aged 60 – 65years, the cases aged ≥ 73 years had decreased proportions of infection through extramarital and noncommercial sex (19.6% 89/455 vs. 24.7% 219/885) and marital sex (4.0% 18/455 vs. 13.6% 120/885), but an increased proportion of the infection through commercial sex (66.2% 301/455 vs. 52.0% 460/885). For the cases infected through heterosexual transmission and having their first CD4⁺T cell detection within one year after the confirmation of HIV infection, 46.5% (818/1 761) were estimated being infected before the age of 60 and 82.7% (1 457/1 761) with a duration of 3 years or more from the infection to the confirmed diagnosis. Of all the older HIV/AIDS patients, 78.3% (1 685/2 152) were diagnosed during screening examination in medical institutions.

  Conclusion  The elder population has become the one of key populations for HIV/AIDS prevention and control; specific and comprehensive interventions should be implemented in the population.