HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Department of Biostatistics and Epidemiology, Faculty of Public Health, Kerman University of Medical Sciences, Kerman, Iran.
Sex Transm Infect. 2023 Mar;99(2):85-90. doi: 10.1136/sextrans-2021-055345. Epub 2022 Apr 22.
This study described the epidemiology and geographical distribution of people diagnosed with HIV in Kerman, Iran, between 1997 and 2020.
We used case-based HIV surveillance data of all people diagnosed with HIV in Kerman between 1997 and 2020. We compared the age, gender, modes of transmission and spatial distribution of newly diagnosed HIV-infected people in three time periods (1997-2004, 2005-2012 and 2013-2020). The χ test for trend, one-sample t-test and Kruskal-Wallis H test were used to compare the differences between the three time periods. We also used ArcGIS to map both HIV services and people living with HIV (PLWH) in 2020. The nearest neighbour index and kernel density were used to identify the spatial distribution of PLWH.
A total of 459 (27.5% women) people were diagnosed with HIV during 1997-2020. The proportion of women (9.3% in 1997-2004 and 48.3% in 2013-2020, p<0.001), HIV infection through sexual contacts (11.6% in 1997-2004 and 50.3% in 2013-2020, p<0.001), HIV infection under the age of 5 years (0.8% in 1997-2004 and 5.4% in 2013-2020, p=0.01) and mean age at diagnosis among men (34.9 in 1997-2004 and 39.8 years in 2013-2020, p=0.004) significantly increased over time. 36.2% of diagnosed cases had CD4 counts under 200 x 10ˆ6/L between 2013 and 2020, with no significant improvement over time. Most newly diagnosed cases of HIV were from the eastern parts of the city. The clusters of PLWH in 2020 matched with the locations of HIV services.
We observed important changes in HIV epidemiology regarding gender, modes of transmission, number of paediatric cases and density maps over time in Kerman. These changes should be considered for precise targeting of HIV prevention and treatment programmes.
本研究描述了 1997 年至 2020 年间伊朗克尔曼省新诊断 HIV 感染者的流行病学和地理分布。
我们使用了 1997 年至 2020 年间克尔曼省所有新诊断 HIV 感染者的基于病例的 HIV 监测数据。我们比较了三个时期（1997-2004 年、2005-2012 年和 2013-2020 年）新诊断 HIV 感染者的年龄、性别、传播途径和空间分布。使用趋势 χ 检验、单样本 t 检验和 Kruskal-Wallis H 检验比较三个时期的差异。我们还使用 ArcGIS 绘制了 2020 年的 HIV 服务和 HIV 感染者（PLWH）地图。最近邻指数和核密度用于识别 PLWH 的空间分布。
1997 年至 2020 年间共诊断出 459 例（27.5%为女性）HIV 感染者。女性比例（1997-2004 年为 9.3%，2013-2020 年为 48.3%，p<0.001）、性接触传播的 HIV 感染（1997-2004 年为 11.6%，2013-2020 年为 50.3%，p<0.001）、5 岁以下儿童的 HIV 感染（1997-2004 年为 0.8%，2013-2020 年为 5.4%，p=0.01）和男性诊断时的平均年龄（1997-2004 年为 34.9 岁，2013-2020 年为 39.8 岁，p=0.004）随时间显著增加。2013 年至 2020 年间，诊断出的病例中有 36.2%的 CD4 计数低于 200 x 10ˆ6/L，且随时间无明显改善。大多数新诊断的 HIV 病例来自城市的东部地区。2020 年 PLWH 的聚集与 HIV 服务的位置相匹配。
我们观察到在克尔曼省，HIV 流行病学在性别、传播途径、儿童病例数量和密度图方面随时间发生了重要变化。这些变化应考虑用于 HIV 预防和治疗计划的精确目标定位。
