Analysis on epidemiological characters and HIV care continuum of HIV-infected students: a retrospective cohort study in Shandong province, China

Abstract

Abstract Backgroud The proportion of HIV-infected students in China showed an increasing trend. This study aimed to identify the epidemiological characteristics and the status of HIV care continuum for HIV-infected students in Shandong Province, China. Methods Case report data and follow-up data of HIV-infected students were obtained from the National HIV/AIDS comprehensive response information management system. Cochran-Armitage trend test was used to analyze the temporal trend of HIV-infected students over these years, Logistic regression analyses were used to analyze the influencing factors of HIV-infected students accepting CD4 + T cells (CD4) test and antiviral therapy (ART) in 30 days, and ArcGIS software was used for the spatial distribution map of student cases. Results From 2017 to 2019, 403 HIV-infected students were reported in Shandong Province, 99.5% was male (401 cases) and 92.1% were homosexual transmitted. They distributed in 96 counties (96/139, 69.1%) of Shandong Province, mainly in Jinan city and Qingdao city. 99.3% (400 cases) received follow-up within 2 weeks, 99.0% (399 cases) acceptted CD4 test, 68.5% (276 cases) acceptted CD4 test in 30 days, 93.8% (378 cases) acceptted ART, and 48.6% (196 cases) started ART in 30 days. Binary Logistic regression analysis showed that the heterosexual transmitted cases (AOR = 0.458, 95%CI: 0.210–0.998), patients accepting HIV care in western Shandong (AOR = 0.266,95%CI: 0.147–0.481) were less likely to detecte CD4 within 30 days; patients aged 23–25 (AOR = 2.316, 95%CI: 1.009–5.316) and patients tested CD4 within 30 days (AOR = 4.377; 95%CI: 2.572–7.447) prefered to receive ART within 30 days; patients accepted HIV care in Central Shandong (AOR = 0.407; 95%CI: 0.251–0.657) and Western Shandong (AOR = 0.508; 95%CI: 0.261–0.989) and patients diagnosed by voluntary blood donation (AOR = 0.352; 95%CI: 0.144–0.864) were less willing to receive ART in 30 days. Conclusions The HIV care continuum of HIV-infected students in Shandong Province still needed strenghthing. More health education and case management should be done for cases transmitted through heterosexual behavior, accepted HIV care in central and western Shandong, and diagnosed by voluntary blood donation.