Characteristics And Associated Factors Of Recently Infected HIV Cases In Four Key Counties Of Liangshan Prefecture,Sichuan Province During 2017-2018

Objective: A comprehensive study was conducted to describe the demographic characteristic and spatial distribution of recently infected HIV cases in four key counties(Butuo,Zhaojue,Meigu,and Yuexi)of Liangshan Prefecture,Sichuan Province from 2017 to 2018.This study explores the application of HIV incidence assay in HIV high burden area,and the results can guide targeted intervention in this area.Methods: 1.The data of newly diagnosed HIV cases were collected from the whole population physical examination in four key counties of Liangshan Prefecture from November 2017 to June 2018.HIV incidence assay and HIV testing history were used to identify recently infected HIV cases.2.Fisher exact test was used to compare categorical data,and logistic regression was used to investigated factors related to HIV recent infection.3.The spatial distribution and risk cluster analysis were conducted by kernel density and Sa TScan,respectively.Spatial regression was applied to identify risk factors associated with HIV recent infection’s spatial variation.Results: 1.A total of 5 555 newly diagnosed HIV cases identified in the whole population physical examination of four key counties of Liangshan prefecture.Among them,246 individuals classified as recently infected.Most newly diagnosed HIV cases were male,and aged between 25 and 49 years accounted the largest proportion.2.Among 217 recently infected HIV cases with fully basic information,most of them were male,and mainly concentrate in aged between 25 and 49 years.They mainly contracted HIV through heterosexual contact,accounted for 76.5% of them.3.Among newly diagnosed HIV cases,women(OR = 1.67,95% CI: 1.24-2.27),primary school education level(OR = 1.41,95% CI: 1.04-1.92)have a higher proportion of recent infection.Compared with contracting through injecting drugs,other transmission routes(OR = 0.39,95% CI: 0.20-0.77)have a lower proportion of recent infection.4.A high-risk area of incident HIV infection were identified by spatial scan analysis(RR = 3.38,P < 0.001).Recently infected HIV cases in this high-risk area were more likely to be female,and young.5.There are significant spatial autocorrelation for incident HIV infection(Moran’s I = 0.76,P < 0.01).According to the results of spatial error regression,elevation standard deviation(β =-0.29,P < 0.001),and distance to local urban area(β =-10.08,P < 0.001)negatively associated with kernel density of incident HIV,and population density positively associated(β = 0.31,P = 0.01).Conclusion: 1.The concurrent HIV epidemic in four key counties of Liangshan Prefecture,Sichuan Province have shifted from former male-dominated injecting drugs transmission to female-dominated heterosexual transmission.Female,and primary school education have a higher proportion of HIV recently infected.2.A high-risk area of incident HIV infection were identified.Recently infected HIV cases in this high-risk area were more likely to be female,and young.3.There are apparent spatial autocorrelation for incident HIV infection.According to the results of spatial error regression,elevation standard deviation,distance to local urban area,and population density are correlated with the kernel density of incident HIV.