Chen Yuanfang, Li An-Dong, Yang Yizhou, Lu Jing, Xu Yu, Ji Xinyu, Wu Liting, Han Lei, Zhu Baoli, Xu Ming
Engineering Research Center of Health Emergency, Jiangsu Provincial Center for Disease Control and Prevention, No.172 Jiangsu Road, Nanjing, 210009, China.
Jiangsu Province Engineering Research Center of Health Emergency, Nanjing, 210009, China.
AIDS Res Ther. 2025 May 6;22(1):51. doi: 10.1186/s12981-025-00745-5.
HIV/AIDS persists as a global health challenge despite significant advancements in antiretroviral therapy (ART). The transformation of HIV into a chronic condition, coupled with regional disparities and evolving epidemiological trends, necessitates an updated analysis of the disease burden.
We conducted a comprehensive analysis of HIV/AIDS burden among individuals aged 15-79 years from 1990 to 2021 using the latest data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 database. Multiple statistical approaches were employed to investigate temporal trends, geographic variations, and health inequalities.
From 1990 to 2021, global HIV/AIDS age-standardized incidence rates (ASIR) decreased by 41%, while age-standardized prevalence rates (ASPR), mortality rates (ASMR), and disability-adjusted life year rates increased by 222%, 57%, and 59%, respectively. Sub-Saharan Africa demonstrated the highest HIV/AIDS ASPR in 2021, with High-middle and Middle SDI regions, particularly Oceania, South Asia, and Eastern Europe, experiencing the most significant ASPR growth over three decades. Joinpoint analysis identified 1997 and 2015 as critical years for ASIR declines, and 2004 for ASMR reductions. Decomposition analysis revealed population growth as the primary driver of increasing incidence in lower SDI regions, while epidemiological changes were more influential in higher SDI areas. The age-period-cohort model showed peak HIV/AIDS incidence among individuals aged 25-34, with diminishing incidence risk across successive birth cohorts and periods. Health inequality analysis from 1990 to 2021 revealed a substantial widening of disparities across countries, with the slope index of inequality rising from 265 to 1006.
While global efforts have reduced HIV/AIDS incidence, increasing prevalence due to extended survival with antiretroviral therapy presents ongoing challenges. Regional disparities and rising incidence among specific demographics underscore the need for sustained, targeted interventions.
尽管抗逆转录病毒疗法（ART）取得了重大进展，但艾滋病毒/艾滋病仍然是一项全球卫生挑战。艾滋病毒转变为一种慢性病，再加上地区差异和不断演变的流行病学趋势，需要对疾病负担进行更新分析。
我们利用《2021年全球疾病、伤害和风险因素负担研究》（GBD 2021）数据库的最新数据，对1990年至2021年期间15至79岁人群中的艾滋病毒/艾滋病负担进行了全面分析。采用了多种统计方法来研究时间趋势、地理差异和健康不平等问题。
从1990年到2021年，全球艾滋病毒/艾滋病年龄标准化发病率（ASIR）下降了41%，而年龄标准化患病率（ASPR）、死亡率（ASMR）和伤残调整生命年率分别上升了222%、57%和59%。2021年，撒哈拉以南非洲的艾滋病毒/艾滋病年龄标准化患病率最高，高中等和中等社会人口指数（SDI）地区，特别是大洋洲、南亚和东欧，在三十年中经历了最显著的年龄标准化患病率增长。连接点分析确定1997年和2015年是年龄标准化发病率下降的关键年份，2004年是年龄标准化死亡率下降的关键年份。分解分析表明，人口增长是低社会人口指数地区发病率上升的主要驱动因素，而流行病学变化在高社会人口指数地区的影响更大。年龄-时期-队列模型显示，艾滋病毒/艾滋病发病率在25至34岁人群中达到峰值，随着出生队列和时期的延续，发病风险逐渐降低。1990年至2021年的健康不平等分析显示，各国之间的差距大幅扩大，不平等斜率指数从265上升到1006。
虽然全球努力降低了艾滋病毒/艾滋病的发病率，但由于抗逆转录病毒疗法延长了生存期，患病率上升带来了持续挑战。地区差异以及特定人群中发病率的上升凸显了持续进行有针对性干预的必要性。
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