He Lin, Pan Xiaohong, Yang Jiezhe, Zheng Jinlei, Cheng Wei, Chai Chengliang
Zhejiang Provincial Center for Disease Control and Prevention, Zhejiang, Hangzhou, China.
Front Public Health. 2025 Apr 30;13:1550565. doi: 10.3389/fpubh.2025.1550565. eCollection 2025.
Effective management of people living with HIV (PLWH) can block the sexual transmission as there is a zero risk of sexual transmission (by U=U campaign); however, few studies have aimed to addressed the risk of transmission among PLWH in China.
We conducted a cross-sectional survey among PLWH in 2022. PLWH were categorized into four HIV transmission risk groups: on antiretroviral therapy (ART) and HIV viral load (VL) < 50 copies/mL as minimum risk; on ART and 50 ≤ VL < 1,000 copies/mL as low-risk; on ART and VL ≥ 1,000 copies/mL, or on ART but without VL testing as medium-risk; not on ART as high-risk. Multivariable logistic regression was used to identify risk factors associated with risk of HIV transmission.
A total of 39,744 PLWH were enrolled in the study. The proportion of those at risk for HIV transmission was 11.4%: low-risk 3.4%, medium-risk 6.9% and high-risk 1.1%. 33,764 (95.0%) patients were tested for syphilis, of whom 5.6% (1,879) had a current syphilis infection. Multivariable logistic regression analysis showed that compared with patients at minimum risk of transmission, individuals who were male (adjusted odds ratio [aOR]: 1.17, 95% confidence interval [CI]: 1.06-1.29), 16-24 age group (aOR: 2.13, 95% CI: 1.75-2.60), primary school or literate (aOR: 1.50, 95% CI: 1.36-1.65), heterosexual route of HIV infection (aOR: 1.50, 95% CI: 1.38-1.63), with a non-local registered residence (aOR: 1.55, 95% CI: 1.39-1.72), current CD4 + T count ≤200 cells/μL (aOR: 5.03, 95% CI: 4.52-2.59), and follow-up years less than 2 years (aOR: 2.02, 95% CI: 1.77-2.30) were associated with increased odds of HIV transmission. Being married (aOR: 0.62, 95% CI: 0.55-0.69) was associated with a decreased risk of HIV transmission.
We concluded that 8.0% of PLWH were at moderate to high risk for HIV transmission. 88.6% of HIV positive patients in Zhejiang province, China were found to be at minimum risk of HIV transmission. Promoting HIV knowledge and education among younger adults, while linking individuals to ART to reduce their viral load could help reduce the persistently risk of HIV transmission.
对艾滋病毒感染者（PLWH）进行有效管理可阻断性传播，因为（依据“U=U运动”）性传播风险为零；然而，针对中国艾滋病毒感染者间传播风险的研究较少。
我们在2022年对艾滋病毒感染者开展了一项横断面调查。艾滋病毒感染者被分为四个艾滋病毒传播风险组：接受抗逆转录病毒治疗（ART）且艾滋病毒病毒载量（VL）＜50拷贝/毫升为最低风险组；接受ART且50≤VL＜1000拷贝/毫升为低风险组；接受ART且VL≥1000拷贝/毫升，或接受ART但未进行病毒载量检测为中等风险组；未接受ART为高风险组。采用多变量逻辑回归分析来确定与艾滋病毒传播风险相关的危险因素。
共有39744名艾滋病毒感染者纳入本研究。艾滋病毒传播风险人群的比例为11.4%：低风险3.4%，中等风险6.9%和高风险1.1%。33764名（95.0%）患者接受了梅毒检测，其中5.6%（1879名）目前感染梅毒。多变量逻辑回归分析显示，与传播风险最低的患者相比，男性（调整优势比[aOR]：1.17，95%置信区间[CI]：1.06 - 1.29）、16 - 24岁年龄组（aOR：2.13,95%CI：1.75 - 2.60）、小学学历或文盲（aOR：1.50,95%CI：1.36 - 1.65）、通过异性传播途径感染艾滋病毒（aOR：1.50,95%CI：1.38 - 1.63）、非本地户籍（aOR：1.55,CI：1.39 - 1.72）、当前CD4+T细胞计数≤200个/微升（aOR：5.03,95%CI：4.52 - 5.59）以及随访年限少于2年（aOR：2.02,95%CI：1.77 - 2.30）的个体艾滋病毒传播几率增加。已婚（aOR：0.62,95%CI：0.55 - 0.69）与艾滋病毒传播风险降低相关。
我们得出结论，8.0%的艾滋病毒感染者存在中度至高度艾滋病毒传播风险。在中国浙江省，88.6%的艾滋病毒阳性患者被发现处于最低艾滋病毒传播风险。在年轻成年人中推广艾滋病毒知识和教育，同时使个体接受抗逆转录病毒治疗以降低其病毒载量，可能有助于降低持续存在的艾滋病毒传播风险。
