Epidemiological analysis of age and spatial differences of HIV prevalence over the last decade in Nanjing, China

Objective: To describe the epidemiological characteristics of PLHIV, and to assess age and spatial distribution of HIV prevalence over the last decade in Nanjing. Methods: We downloaded information of the reported PLHIV from Chinese HIV/AIDS comprehensive prevention system, and we performed descriptive, one-way ANOVA, autocorrelation analysis, spatial scanning and mapping of spatial distribution. Results: 5269 PLHIV that fulfilled the inclusion and exclusion criteria were included to our study. The HIV prevalence for each year rose from 1.09/10000 in 2011 to 5.70/10000 in 2020. The dominate transmission was sexual route. Homosexual transmission showed an upward trend from 61.5–74.5%, and decreased slowly to 62.9%, the proportion of drug injection transmission decreased from 10.6–0.2%. The characteristics of transmission routes, disease stage and the diagnosis way were different among three age groups, and the difference were statistically significant with all P<0.001. The spatial autocorrelation analysis showed that the spatial clustering of HIV prevalence existed among three age groups in 2016 and 2020. By the end of 2020, HIV prevalence clustering districts among Youth were Qinhuai, Gulou, Xuanwu, Qixia, Jiangbeinewarea. HIV prevalence clustering districts among Middle-aged were Qinhuai, Gulou, Xuanwu, Jianye, Yuhuatai, HIV prevalence clustering districts among Elderly were Qinhuai, Gulou, Xuanwu, Qixia. Conclusion: The steadily increasing HIV prevalence rate, the late diagnosis of Elderly, the expansion of the clustering districts among Youth, and the key clustering districts like Qinhuai and Gulou where risk factors exist all posed challenges to the prevention and control of HIV in Nanjing. Societal and medical resources should be deployed to deal with HIV epidemic under the consideration of the variation of age and geographic regions.