Objective To describe epidemiological characteristics of newly reported human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients in Fujian province through constructing a HIV molecular transmission network for effective prevention and control of HIV infection.

Methods Blood samples were collected and HIV RNA were extracted from 1 136 newly reported antiretroviral therapy-naïve HIV/AIDS patients in Fujian province in 2020. With HIV subtype B primers, HIV gene sequences of the HIV/AIDS patients were obtained by reverse transcription PCR using a self-established genotypic drug resistance detection method. A molecular transmission network was constructed for the HIV/AIDS patients based on the analysis using HIV-TRACE.

Results Of the 908 participants with valid HIV gene sequencing results, 763 (84.03%) were males; 697 (76.76%) were aged 20 – 59 years; 852 (93.83%) were infected via sexual transmission; 351 (38.66%) had low education (illiteracy or primary school education); and 426 (46.92%) were married. The predominant HIV genotypes for the participants were CRF07_ BC and CRF01_ AE, together accounting for 82.49% of the infections. Drug resistance was detected in 48 (5.3%) of the participants. Under the 1.5% gene distance threshold, 108 molecular transmission clusters were established for 377 (41.52%) of the participants, with the largest cluster of CRF01_ AE subtype, 23 cluster nodes, and 21 clusters having 4 or more nodes. The results of multivariate logistic regression analysis showed that the participants aged 60 years and older (odds ratio OR = 1.875, 95% confidence interval 95%CI: 1.215 – 3.241), being infected with subtype CRF07_ BC (OR = 2.112, 95%CI: 1.632 – 3.211) or CRF01_AE (OR = 1.987, 95%CI: 1.411 – 3.645), and being married (OR = 1.713, 95%CI: 1.245 – 2.487) were more likely to enter a molecular transmission network; but the participants having drug resistance were less likely to enter a molecular transmission network (OR = 0.195, 95%CI: 0.134 – 0.326) compared to those not having drug resistance.

Conclusion Among HIV/AIDS patients in Fujian province, molecular transmission network-related HIV infection was prevalent and influence by multiple factors; drug resistance was also prevalent among antiretroviral therapy-naïve HIV/AIDS patients. The study results should be concerned in regional HIV/AIDS control and prevention.