Community-based HIV Testing in Southern China: Implementation and Results from a District-level Campaign

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Nehl, Wancha Huang, Xuan Lin, Mingfeng Li, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7119195/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 8 You are reading this latest preprint version Abstract Background Community-based testing campaigns (CTC) are critical for HIV prevention and treatment, particularly in regions like Southern China where targeted interventions are needed to address transmission dynamics and improve care access. Using data collected during the implementation of a CTC, we aim to evaluate antiretroviral therapy (ART) uptake, identify priority groups for treatment and prevention, discover factors associated with testing positive for Human immunodeficiency virus (HIV), and evaluate potential transmission-route changes among youth participants. Methods Testing discovery coefficients (TDC) of HIV-infected individuals and cross-stratifications were calculated among different demographic groups. The proportion of patients who were aware of their HIV infection status, and ART coverage were recorded. Multivariate logistic regression analysis was used to identify the factors which impacted HIV testing positively, and a random forest plot was used to visualize the predictive factors. Results 15,805 people tested for HIV and 30 individuals were identified as newly HIV positive. The testing positive rate was 19/10,000 and the TDC was 6.8% (30/440). The TDC among females was 11.4% (10/88). The TDC among people aged 15–24 was the highest, accounting for 16.1% (9/56). Among the newly HIV positive, those 15–44 years old were primarily infected through men having sex with men (MSM) contact, accounting for 43.3% (13/30) of the new identifications. The proportion of new patients receiving ART after screening was 96.7% (29/30). Predictors of testing positive were being male (OR = 3.372, 95%CI: 1.578–7.211). Conclusions MSM behavior was identified as the main transmission route among those newly infected with HIV in urban Nanning, Southern China. CTC is an effective strategy, leading to a higher yield of HIV and acquired immune deficiency syndrome (AIDS) diagnoses, particularly for female and younger participants. CTC also improved ART uptake among those newly identified as being HIV positive. HIV community-based testing MSM young adults testing discovery coefficients Figures Figure 1 Figure 2 Figure 3 1 Introduction HIV remains one of the most significant public health challenges worldwide, especially in low- and middle-income countries. According to the data from the World Health Organization (WHO), [ 1 ] it has claimed the lives of 40.4 million people [32.9–51.3 million] to date and continues to spread globally. Alarmingly, some countries with previously declining incidence rates are reporting an increasing trend in new infections. Despite increasing efforts in HIV/AIDS awareness campaigns globally, [ 2 , 3 ] public knowledge and understanding of the disease remain insufficient. This gap is often associated with low educational attainment, residence in rural areas, and a lack of educational initiatives. [ 4 , 5 ] Global evidence indicates that in 2020, only 84% of HIV-positive individuals were aware of their status, 87% of them had access to antiretroviral therapy (ART), and 90% of those on ART had their viral loads suppressed. HIV positive individuals being aware of their status can reduce the probabilities of HIV transmission through behavioral change, such as condom use, avoiding sharing needles, or participation in mother-to-child transmission prevention programs. Conversely, those HIV positive individuals who are not aware of their status may experience delayed diagnosis and treatment, lead to higher morality and increased transmission. Knowing one’s status is also essential for initiating ART, which offers the benefits ofreducing virus load, promoting immune reconstitution, eliminating opportunistic infections and enjoying a normal life. Five priority populations (men who have sex with men, people who inject drugs, sex workers, transgender people, and individuals in prisons or other closed settings) are disproportionately affected by HIV. These populations and their sexual partners account for 65% of global HIV infections. [ 6 ] The Global HIV Prevention Coalition (GPC) also reported that only 44% of sex workers, 28% of men who have sex with men, and 37% of people who inject drugs received two or more HIV prevention services in the past three months. [ 7 ] The progress of HIV education and prevention programming is far from reaching the 95%-95%-95% target by 2030 [ 1 ]. On a global scale, community-based HIV screening has been implemented as a crucial measure for the early detection and treatment of HIV-infected individuals. The widespread use of the campaign has led to the diagnosis of a significant number of previously unidentified HIV-infected individuals, providing them with valuable opportunities for early treatment. The promotion of screening has also enhanced public understanding of HIV prevention and reduced stigma. Screening data serves as vital evidence for developing and implementing HIV prevention and control strategies, playing a significant role in achieving the goal of ending AIDS by 2030. [ 8 – 9 ] As a result, community-based HIV screening campaign have been implemented in high HIV/AIDS disease burden settings. For example, to identify the optimal methods for maximizing population-level testing coverage, a door-to-door census, multi-disease community health campaign that included HIV testing was launched in rural Kenya and Uganda. Results from this campaign demonstrated a high HIV testing coverage of a hybrid, mobile approach in both countries. [ 10 ] To assess factors associated with HIV infection among youth, a Community Health Initiative was also implemented in an urban areas of western Kenya. Their findings highlight the need for HIV prevention programs specially tailored for youth to further reduce new HIV infections in the community. [ 11 ] To identify individuals who are unaware of their HIV-positive status and achieve testing saturation, a second study in western Kenya was implemented with a hybrid HIV testing approach in an urban area to describe the uptake of HIV testing and linkage to care and treatment during the program. [ 12 ] This community-based HIV testing program successfully identified people who are unaware of their HIV-positive status and achieved testing saturation. [ 13 , 14 ] However, challenges remain for community-based testing campaigns focusing on universal testing, the uptake of HIV testing and linkage to care and ART among men and young populations in China. According to data from the Chinese Center for Disease Control and Prevention, sexual transmission has become the primary route of HIV infection in China. In recent years, over 95% of reported cases in China have been attributed to sexual transmission. Heterosexual transmission comprises approximately 70%, while transmission among MSM accounts for about 25%. Meanwhile, the number of HIV infections among young Chinese has significantly increased, with an annual growth-rate of newly diagnosed among college students ranging from 30–50%. One study indicated that in Guangxi, Southern China, 70.7% of young students are infected with HIV through MSM rather than heterosexual contact. [ 15 , 16 ] The challenge posed by HIV infections among young individuals, particularly transmitted through MSM behavior has emerged as a major obstacle to achieving the goal of ending HIV transmission in China. Previous campaigns have successfully identified those who are HIV seropositive and have allowed for timely access to ART services and referral to the National HIV Program (NHP) services. Additionally, those seronegative individuals with high-risk behaviors for HIV infection are referred to a menu of biomedical HIV intervention and prevention tools provided through local NHP or non-government organizations (NGOs). However, population-level testing coverage and the optimal method for extending screening among MSM population continue to be significant challenges. Therefore, our article focuses on a community-based HIV screening campaign carried out in a university communities in southern China. Our results explore the optimal methods to involve younger Chinese in CTC and to demonstrate the results of a population-wide testing campaign with a door-to-door census, public mobilization of HIV testing, and evaluate the uptake of HIV testing and linkage to care and ART during this program. By collecting, organizing, and analyzing data, we examine the implementation, effectiveness, and the challenges of CTC in university communities in China. 2 Methods 2.1 Study design and settings To identify individuals infected HIV in an earlier stage and those who are unaware of their HIV-positive status, a community-based HIV testing campaign was performed in South Xiuling District, one of the districts in urban Nanning, Southern China, with a population size of 108,148 and four surrounding universities, e.g. Guangxi University, Guangxi Industrial Technologic College, Guangxi College of Finance and Economics, and Nanning Commercial and Trade School. These are communities characterized by large youth populations, dense clusters of surrounding universities, and a rising number of HIV-positive individuals due to MSM transmission. 2.2 Study population and data collection methods Residents of the eight communities in Xiuling District have participated in CTC. We randomly sampled from the initial population of 108,148 people who aged fifteen and above. Only those with negative HIV tests record before participating in the CTC from January 2023 to December 2023 were considered repeat testing. The urban HIV TDC rate was calculated based on historical positive diagnosis data within the community and newly identified positive diagnoses, fusing on discovery rates by age group and transmission route. 2.3 CTC Implementation Process We used a two-stage sampling approach to identify participants. In the first stage, we randomly selected eight communities, in which a total of 108,148 people participated in the screening. First, population in communities of Xiuling District underwent census enumeration followed by mobile HIV testing services. Using a door-to-door census approach, we conducted public mobilization, voluntary counseling and testing (VCT), collection of blood samples, laboratory testing and confirmation of HIV. All staff participating in blood collection and HIV testing had medical backgrounds and adhered to medical ethics and safety standards, respecting participants' privacy and informed consent throughout the entire process. Staff used disposable equipment for blood collection to ensure the safety and hygiene of sampling. Those with HIV-positive test results were referred to the local CDC for confirmation and initiation of ART treatment. Demographic characteristics of those diagnosed with HIV/AIDS were collected for comparison and analysis (Fig. 1 ). 2. 4 Statistical analysis A generalized additive model was used as a preliminary step using personal demographic characteristics for variable selection. Covariates were removed one by one until a model with minimum Akaike information criterion (AIC) was attained. Chi-square tests were used to assess differences among personal demographic characteristics between those newly testing-positive and those previously positive for HIV. Variables with significant differences (P < 0.05) were incorporated into a final multivariable logistic regression model to evaluate their impact on the HIV-testing results. Preliminary statistical analysis was performed using R (version 4.4.1), and corrections were analyzed using Stata/MP 17. 3 Results 3.1 Baseline characteristics of the testing-participated adults From January 15 to December 8, 2023, 31,954 individuals were eligible for HIV testing services in 8 communities of an urban area. Subsequently, 15,805 (49.5%) accepted testing, of which 5,883 (37.2%) were males, 9,922 (62.8%) were female; 4,214 (26.7%) were aged 60 years or older, and 7,004 (44.3%) were college students. There were statistically significant differences by gender (χ 2 =684.81, P < .001), age-groups (χ 2 =71.07, P < .05) and educational levels (χ 2 =30.78, P < .001). The age of participants ranged from 15 to 101 years old with an average age of 36.51 (36.51 ± 22.7) years. The majority were 15-24 years old (50.1%, 7,914/15,805), 15,450 (97.8%) were first-time testers (male 37.4%, female 62.6%), and 355 (2.2%) were repeat testers (Table 1). 3.2 Community-based HIV testing results 3.2.1 Epidemiological characteristics of newly identified HIV cases A total of 58 individuals tested positive for HIV during the initial testing in the CTC. Three participants were confirmed negative after a confirmation test. Among the 55 who were confirmed HIV positive, 25 had been diagnosed previously and 30 (0.2%, 30/15805) residents were newly identified as HIV-positive. Among those newly identified HIV cases, 20 were males (20/30, 66.7%) and 10 were females (10/30, 33.3%). Ages of those newly diagnosed ranged from 16 to 91 years old with an average age of 36 (36±22.73) years, with the majority in the 25-44 age-group (12/30, 40%). The majority were of Han ethnicity (27/30, 90%), married (12/30, 40%), with a education attainment of junior high school (15/30, 50%). They predominantly acquired the infection through heterosexual (17/30, 56.7%) or 43.3% (13/30) MSM sexual behavior. 3.2.2 HIV identification among those 15-44 In the age-group 15-44, there were a total of 21 (70%, 21/30) individuals newly diagnosed with HIV, including 16 (76.2%, 16/21) males and 5 (23.8%, 5/21) females. The majority were unmarried (16/21, 76.2%), and the main route of infection was MSM behavior (13/21, 61.9%). In the 15-24 age-group, 7 out of 9 individuals were infected through MSM behavior (77.8%), while in the 25-44 age-group, 6 out of 12 were infected through MSM behavior (50%). 3.3 Comparison between those newly testing positive HIV individuals and previous HIV diagnosis 3.3.1 Demographic characteristics of newly testing positive HIV cases and previously identified HIV/AIDS and the testing discovery coefficients (TDC) From January 2015 to 2023 December, there were a total of 440 people living with HIV (PLHIV, including 30 individuals newly identified as HIV positive in the CTC). The TDC (defined as individuals newly diagnosed HIV positive divided by the sum of individuals previously confirmation and those newly identified HIV-positive) was 6.82% (30/440). A total of 410 residents had been previously diagnosed HIV/AIDS (Table 2). Compared to those who were newly identified as HIV positive, those previously identified 332 were males (80.98%, 332/410), with a male discovery coefficient of 5.68% (20/352), and a male prevalence rate of 0.64% (352/55350); 78 were females (78/410, 19.02%), with a female discovery coefficient of 11.36% (10/88), and a female prevalence rate of 0.17% (88/52797). The age-group primarily affected was 25-44 years old (236/410, 57.56%), with the 15-24 age-group having the highest discovery coefficient at 16.07% (9/56); the marital status was predominantly unmarried (242/410, 59.02%); and the main mode of transmission was heterosexual (208/410, 50.73%). Statistical significance was found in age-group (χ 2 =9.459, P = .024) and ethnic groups (χ 2 =18.761, P < .001) when compared to the previous identification. Among the newly discovered HIV-positive cases in CTC, MSM was the predominant route of HIV infection in youth age-group (15-44 years old), accounting for 43.33% (13/30) of the newly identified as HIV positive in CTC (Table 2). 3.3.2 ART Uptake and viral load （ VL ） of newly identification as HIV positive 83.9% of those previously diagnosed with HIV/AIDS reported receiving ART (344/410). Out of the 30 confirmed HIV positive, 29 (96.7%) initiated ART (one patient died during the course of the study) with a TDF+3TC+EFV regimen (Tenofovir disoproxil + Lamivudine + Efavirenz). Compared to those with a previous diagnosis of HIV/AIDS, there was no statistically significant increase of ART uptake among newly identified as HIV positive (96.7% vs. 83.9%, χ 2 =2.61, P = .40). Among those previous diagnosed with HIV/AIDS, the baseline CD4+ T cell count was 373.46 cell/μL (373.46±198.79).Among those newly identified as HIV positive individuals, the baseline CD4 + T cell count was 327.57 cell/μL (327.57±135.15). There was no significant difference between those with a previous diagnosis of HIV and those identified at CTC (t = -1.227, P = .51) (Fig.2 a). The baseline VL was 100,977.56 copies among those previously diagnosed and was 151,839.91 copies among those newly diagnosed. Compared to those with previous diagnosis, the baseline VL of those newly identified was significant higher (χ 2 = 16.033, P = 6.2×10 -5 ) (Fig.2 b). 3.4 Multivariate logistic regression analysis of prediction factors impact HIV testing results According to the Logistic regression analysis results, factors impeding HIV/AIDS are related to male [odds ratio (OR) = 3.372, 95% confidence interval (CI): 1.578-7.721]; 25-44 years old (OR = 3.871, 95% CI: 1.629-6.197), >59 years old (OR = 0.626, 95%CI: 0.269-2.314); Zhuang (OR =1.408, 95% CI:0.427-4.645); junior high school (OR = 1.780, 95% CI) 0.515-6.164) and college degree or above (OR = 0.141, 95% CI: 0.023-0.843) (Fig. 3 and Table 2). 4 Discussion To our knowledge, this is the first implementation of an HIV CTC in Southern China, which has long been considered a high transmission risk area among the provinces of China. The CTC provided HIV testing in the urban areas in South Xiuling District, to discover those newly infected with HIV. Those newly identified as HIV positive were then directed to the services of NHP, including HIV care and ART. The CTC has enumerated 50% of the local residents who were eligible for HIV testing accepted testing. after the campaign. Consistent with similar research, considering the HIV incidence, TDC, HIV prevalence, and awareness of HIV status, CTC is recommended as a public health approach that should be expanded to other high HIV risk areas of China as the results of this study show that it served a crucial role in earlier HIV detection, [ 17 , 11 , 12 ] and was a step towards achieving the goal of ending AIDS by 2030. [ 18 , 19 ] MSM behavior has been increasing as the predominant HIV transmission route among young adults in urban areas in China. The proportion of those infected through MSM transmission is increasing toward the proportion of heterosexual transmission. A number of studies previously found that the predominant HIV-transmission route in Guangxi was injection drug use, [ 20 , 21 ] which then shifted to heterosexual sexual contact, [ 22 , 23 ] Similar to other countries, [ 24 ] HIV transmission through MSM behavior has emerged as a public health priority, with an average prevalence of HIV among MSM in China of 5.7% between 2001 and 2018, [ 25 ] and in Guangxi, Southern China up to 6.53%. [ 26 ] HIV transmission risk-factors associated with MSM were age, education background, and occupation, [ 27 ] Because of sensitivity, and social stigma, HIV screening uptake in the MSM population is limited. [ 28 ] However, higher sexual risk, young age and being identified as MSM has been positively correlated with HIV positive testing. [ 29 ] Our research confirmed that HIV transmission in newly identification among MSM increased to 61.90% among individuals who were 15–44 years old. South Xiu Ling district is a community with five universities; more than 7,000 university-students were involved in the CTC; they are young and have a high education background. The characteristics of the majority of participants of the CTC are consistent with MSM in previous studies and may help explain the elevated HIV transmission through MSM in our study. [ 27 ] The findings in our study emphasize that MSM college students should be a priority population for HIV prevention and control, [ 30 ] and that HIV/AIDS-related education and prevention should be promoted on campus, such as increasing the uptake of ART within students who HIV are positive, and encouraging condom-use during sex among MSM. [ 31 ] Our study found that the majority of CTC participants were those aged 15–24 years, followed by older people aged > 59 years and young adults aged 25–44 years. This finding may reflect the reality that both young and old in the urban districts are seeking testing. HIV prevention education efforts that have been implemented in Guangxi may have contributed to the promotion of HIV testing uptake. Our findings are consistent with the findings of testing motivation study elsewhere. [ 32 ] 97.8% of the participants were first-time testers. Among them, 37.4% were male and 62.6% were female. HIV-testing uptake among males was substantially lower than females. A similar testing gap has been observed in Zambia. [ 33 ] However, even with a low HIV-testing uptake, the HIV yield among males was substantially higher than females in our study. It suggests that being male in urban areas in Guangxi is one of the independent predictors of HIV infection. The reasons for male less involvement in the testing may be due to their responsibility of work, less trust of the health system, and the social stigma during seeking the testing. For example, research has found that conversations about acceptance of HIV testing may make men feel awkward and this may decrease the willingness of male HIV testing. [ 34 ] Building trust, incorporating HIV testing in multiple-diseases testing services, and enabling access to their health care needs are urgently needed to close gaps in HIV testing. Although males produced the majority of newly identification of HIV positive in CTC, an increasing TDC among females was observed. The TDC ratio in male and female was 5.68 : 11.36. this observation may reflect female individuals were missed by traditional testing activities or are in a higher risk of HIV infection recently. HIV yield was higher among males, 45–59 of age, Han ethnicity, and a junior high-school education. Considering most participants were first time testers, these findings indicate that these population groups have higher incidence rate than others. Individuals in these groups may be participating in high-risk behaviors for HIV infection such as commercial sex among the elder generations and MSM in young male. Commercial sex in 45–59 years of male has previously been reported as the highest risk group of HIV transmission in Guangxi, Southern China. [ 26 , 35 , 36 ] CTC was able to identify these groups as priorities for testing. TDC in residents of female, 15–24 years of age, Han ethnicity, and a high-school education background are higher. These results may also indicate that CTC is more successful at reaching these groups. HIV prevalence in younger generations in Guangxi, Southern China has been increasing in recent years, [ 37 ] and the trend is consistent with the global HIV epidemic. [ 38 ] ART uptake among individuals who have been previously diagnosed with HIV/AIDS is challenging. Only 83.90% of those with a previous diagnosis of HIV/AIDS reported receiving ART in South Xiuling district. However, an increasing trend of initiating ART uptake was observed among those newly identified as HIV positive in CTC with 96.67% of the newly identified initiating ART. High ART uptake was part of HIV testing campaign. [ 39 ] We highlight here that the CTC is an essential tool to reached the UNAIDS testing and treatment targets of 95%. We recognize limitations in this study. First, the CTC in 2023 only covered 50% of the population in the community. A staffing shortage necessitated this testing strategy and plans have been developed to cover the remaining population in 2024. Second, it was difficult to document information for those who refused to test for HIV. Third, we could not evaluate virus-suppression status after ART initiation for those newly identification because the ART period has currently not been long enough. The CTC identified that the priority groups for HIV testing include males, youth, those 45–59, MSM, and university communities. The urban areas in Guangxi, Southern China are facing a complex situation, where MSM and heterosexual are facing high HIV transmission. Our findings indicate that community health campaigns are a promising strategy as they are efficient at reaching those who are unaware of their HIV infection status. CTC is an essential tool to achieve the goals of 95% -95%-95% target set by UNAIDS in countries and regions struggling with low HIV testing uptake and ART coverage. Innovative initiatives are needed, with focused attention on access to HIV testing in high-risk groups such as MSM and young men. Declarations Ethics approval and consent to participate This study has been approved by the Medical Ethics Committee of the Sixth People's Hospital of Nanning City, with ethics approval number: 2024102301. Consent for publication Not applicable. Availability of data and materials Data availability statement. All data in this study are available upon request by contact with the corresponding author. Competing interests The authors declare that they have no competing interests. Funding This research was funded by China National Natural Scientific Fund (NO. 82460390) ；Research Initial Fund for Introduced Doctor of Guangxi University of Chinese Medicine (NO.2022BS019). Authors' contributions Authors’contributions: YH and JW collected the data. YL, WH, XL, and ML implemented the survey and collected the samples. JX and ZL made substantial contributions to the conception and design of the work. JH and ZZ contribute to the analysis of the data and literature review as well. JH and YL wrote the draft manuscript. ZZ and EN made major contributions to the interpretation of the results and substantively revised the work/manuscript. All authors have approved the submitted version. Acknowledgements We express gratitude to the staff who participated in the CTC at the HIV treatment center and the Southern Xiuling Community health services center. 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AIDS Behav 2022;26(11):3563 − 75. http://dx.doi.org/10.1007/s10461-022-03679-5. Kabiru CW, Beguy D, Crichton J, Zulu EM. HIV/AIDS among youth in urban informal (slum) settlements in Kenya: what are the correlates and motivations for HIV testing? BMC Pub Health. 2011;11:685. Zambia Statistics Agency, Zambia Ministry of Health, ICF. Zambia Demographic and Health Survey 2018 [Internet]. Lusaka, Zambia; Rockville, MD: Zambia Statistics Agency, Ministry of Health, and ICF; 2019. https://dhsprogram.com/pubs/pdf/FR361/FR361.pdf. Fleming, PJ, Colvin, C, Peacock, D, et al. What role can gender-transformative programming for men play in increasing men's HIV testing and engagement in HIV care and treatment in South Africa? CULT HEALTH SEX. 2016; 18 (11): 1251-64. Tong Luo, Fei Zhang, Huayue Liang, Dee Yu, Ping Cen, Shanmei Zhong, et al. Men with a history of commercial heterosexual contact play essential roles in the transmission of HIV-1 CRF55_01B from men who have sex with men to the general population in Guangxi, China. Front Cell Infect Microbiol. 2024 Aug 23:14:1391215. doi: 10.3389/fcimb.2024.1391215. Zheng Z, Li Y, Jiang Y, Liang X, Qin S, Nehl EJ. Population HIV transmission risk for serodiscordant couples in Guangxi, Southern China: A cohort study. Medicine (Baltimore). 2018 Sep;97(36):e12077. doi: 10.1097/MD.0000000000012077. Liu, H, Zhu, Q, Zhang, L, et al. HIV-Related Knowledge, Attitude, and Practices Research Among College Students - Six Chinese Cities, 2021. China CDC Wkly. 2022; 4 (47): 1043-1050. Slogrove, AL, Mahy, M, Armstrong, A, et al. Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic. J Int AIDS Soc. 2017; 20 (Suppl 3): 21520. Neuman, M, Fielding, KL, Ayles, H, et al. ART initiations following community-based distribution of HIV self-tests: meta-analysis and meta-regression of STAR Initiative data. BMJ Glob Health. 2021; 6 (Suppl 4). Tables Table 1 . Demographic characteristics of participants in the CTC Participants （ N=15805 ） Variables n % c 2 values P -value Gender 684.81 < .001 Male 5883 37.22 Female 9922 62.78 Age (years) 71.07 59 4214 26.66 Nationality - - Han 13526 85.58 Zhuang 2116 13.39 Other Ethnic Groups 163 1.03 Marital status 2.72 0.281 Single 9219 58.33 Married 5184 32.80 Divorced or widowed 1189 7.52 Unclear 213 1.35 Education degree 30.78 < .001 Primary school 3176 20.09 Junior high school 4147 26.24 High school 1478 9.35 College and above 7004 44.32 Table 2 . Factors related to the HIV positive among newly identification and previous diagnoses Accepted HIV testing （ N=15805 ） Newly identification （ N=30 ） Previous diagnosis （ N=410 ） HIV yield （ % ） TDC (%) c 2 value Variables Test positive （ n ） Proportion (%) Test positive （ n ） Proportion (%) c 2 value Gender 3.58 27.67** Male 5883 20 66.67 332 80.98 0.34 5.68 Female 9922 10 33.33 78 19.02 0.10 11.36 Age (years) 8.05 a * 87.17** 15-24 7914 9 30.00 47 11.46 0.11 16.07 25-44 2726 12 40.00 236 57.56 0.44 4.84 45-59 951 6 20.00 72 17.56 0.63 7.69 >59 4214 3 10.00 55 13.41 0.07 5.17 Nationality 18.76** 15.61** Han 13526 27 90.00 204 49.64 0.20 11.71 Zhuang 2116 3 10.00 186 45.26 0.14 1.59 Other Ethnics 163 0 0 21 5.11 0 0 Marital status 2.66 3.78 Single 9219 16 53.33 242 59.02 0.17 6.20 Married 5184 12 40.00 113 27.56 0.23 9.60 Divorced or widowed 1189 2 6.67 55 13.41 0.17 3.51 Unknown 213 - - - - - - Education Degree 6.99 9.35* Primary school 1478 3 10.00 50 12.20 0.20 5.66 Junior high school 4147 15 50.00 201 49.02 0.36 6.94 High school 3176 10 33.33 70 17.07 0.31 12.50 College and above 7004 2 6.67 89 21.71 0.03 2.20 Route of infection 2.73 a - Homosexual - 13 43.33 189 46.10 - 6.44 Heterosexual - 17 56.67 208 50.73 - 7.56 Inject drug users - 0 0 9 2.20 - 0 Unknown/other - 0 0 4 0.98 - 0 TDC= newly diagnosed HIV positive / (previously confirmed + newly diagnosed HIV positive) *100% HIV yield= Number of new HIV diagnoses/number of people tested (N)*100% * P < .05, ** P <.01, *** P <.001; a denotes fisher's exact test. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 23 Aug, 2025 Reviews received at journal 22 Aug, 2025 Reviewers agreed at journal 20 Aug, 2025 Reviewers invited by journal 08 Aug, 2025 Editor invited by journal 18 Jul, 2025 Editor assigned by journal 15 Jul, 2025 Submission checks completed at journal 15 Jul, 2025 First submitted to journal 14 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7119195","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":498604903,"identity":"24d6eafc-dfb7-4b95-9f9c-a8b05a9c9a60","order_by":0,"name":"Jinda He","email":"","orcid":"","institution":"Guangxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Jinda","middleName":"","lastName":"He","suffix":""},{"id":498604904,"identity":"077a32c0-c13a-4257-9c3c-68dba4c0d005","order_by":1,"name":"Ying Liu","email":"","orcid":"","institution":"Sixth People Hospital of Nanning City","correspondingAuthor":false,"prefix":"","firstName":"Ying","middleName":"","lastName":"Liu","suffix":""},{"id":498604905,"identity":"3f09bd5a-9358-45d5-aea0-ca429cc89f34","order_by":2,"name":"Eric J. Nehl","email":"","orcid":"","institution":"Emory University","correspondingAuthor":false,"prefix":"","firstName":"Eric","middleName":"J.","lastName":"Nehl","suffix":""},{"id":498604906,"identity":"970c4858-2804-441a-925d-b0e8e9d48415","order_by":3,"name":"Wancha Huang","email":"","orcid":"","institution":"Sixth People Hospital of Nanning City","correspondingAuthor":false,"prefix":"","firstName":"Wancha","middleName":"","lastName":"Huang","suffix":""},{"id":498604907,"identity":"6da2cbd5-ea3a-49ac-a3a2-28811ab34a2b","order_by":4,"name":"Xuan Lin","email":"","orcid":"","institution":"Sixth People Hospital of Nanning City","correspondingAuthor":false,"prefix":"","firstName":"Xuan","middleName":"","lastName":"Lin","suffix":""},{"id":498604908,"identity":"462f22b9-17cd-4bd9-acad-15a4c55fae67","order_by":5,"name":"Mingfeng Li","email":"","orcid":"","institution":"Sixth People Hospital of Nanning City","correspondingAuthor":false,"prefix":"","firstName":"Mingfeng","middleName":"","lastName":"Li","suffix":""},{"id":498604909,"identity":"01d6c6e4-2816-44f6-b24a-fe7e3ba33727","order_by":6,"name":"Binbin Wen","email":"","orcid":"","institution":"Guangxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Binbin","middleName":"","lastName":"Wen","suffix":""},{"id":498604910,"identity":"c3f6c0cb-4b4a-4b91-961d-2ca08d5545e1","order_by":7,"name":"Yanan Hou","email":"","orcid":"","institution":"Guangxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Yanan","middleName":"","lastName":"Hou","suffix":""},{"id":498604911,"identity":"c62600fa-4a7e-407d-a149-cd59afaa1465","order_by":8,"name":"Jiangshan Wang","email":"","orcid":"","institution":"Guangxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Jiangshan","middleName":"","lastName":"Wang","suffix":""},{"id":498604912,"identity":"beee8e30-3a84-41ee-ab0c-eecf5d4c27db","order_by":9,"name":"Zhaohua Lu","email":"","orcid":"","institution":"the Sixth People Hospital of Nanning City","correspondingAuthor":false,"prefix":"","firstName":"Zhaohua","middleName":"","lastName":"Lu","suffix":""},{"id":498604913,"identity":"a0927c6e-cc48-4a9d-8732-d5246ab2bb38","order_by":10,"name":"Jian Xiao","email":"","orcid":"","institution":"Guangxi University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Jian","middleName":"","lastName":"Xiao","suffix":""},{"id":498604914,"identity":"a391a0dd-0d58-4b06-a77f-afb3e4190d3d","order_by":11,"name":"Zhigang Zheng","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3klEQVRIiWNgGAWjYDACZijNLwGmJGQI6uCBaZGcwcDYANTCQ1gLjGFwA6yFgbAWe3beY5Jfau7Ybb7dfPzRjRoLHgb2w0c34HcYX5q0zLFnydvuHEtszjkGdBhPWtoN/Fp4zKQl2A4nm93IMWzOYQNqkeAxI0LLv8PJxjNAWv4RqUXyY9thOwMJoJbcNmK0HOYxtmbsO5wgcSMtcXZunwQPGyG/sPefMbz549the/4ZyQc+53yrk+NnP3wMrxYgYJEGxkViA4zLRkA5CDB//AGMHyIUjoJRMApGwUgFAEMxQzYq6ee8AAAAAElFTkSuQmCC","orcid":"","institution":"Guangxi University of Chinese Medicine","correspondingAuthor":true,"prefix":"","firstName":"Zhigang","middleName":"","lastName":"Zheng","suffix":""}],"badges":[],"createdAt":"2025-07-14 09:08:29","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7119195/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7119195/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":89231352,"identity":"82ef2557-4455-4096-980d-d03b87dde361","added_by":"auto","created_at":"2025-08-17 14:19:08","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":175611,"visible":true,"origin":"","legend":"\u003cp\u003eFlow chart of the CTC processes.\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7119195/v1/00428da95902da7e4e52469e.jpeg"},{"id":89231354,"identity":"eb3dce7b-ab4a-4009-93a1-b19831b25908","added_by":"auto","created_at":"2025-08-17 14:19:08","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":123107,"visible":true,"origin":"","legend":"\u003cp\u003eThe initial CD4+ T cell count and VL among those newly identified as HIV positive in CTC and previous diagnosis as HIV/AIDS. Fig.2 b (right) showed that the higher initial VL among newly diagnosis was observed ((χ\u003csup\u003e2\u003c/sup\u003e = 16.033, \u003cem\u003eP \u003c/em\u003e= 6.2×10\u003csup\u003e-5\u003c/sup\u003e).\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7119195/v1/ad867c68970dd28dd1a2ac0a.png"},{"id":89231357,"identity":"058e7576-6300-4574-bc7a-cbd9e50b4d40","added_by":"auto","created_at":"2025-08-17 14:19:09","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":193611,"visible":true,"origin":"","legend":"\u003cp\u003eForest plot for the factors that associated with HIV tested positive between newly identification and previous diagnosis of HIV/AIDS by logistic regression model.\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7119195/v1/77ef49bcc4ff737943858de5.png"},{"id":89233872,"identity":"6be43976-8ee4-4876-9a56-02da29b26d9a","added_by":"auto","created_at":"2025-08-17 14:43:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1587591,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7119195/v1/22c5b397-00d2-4981-a165-224da4ee807e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Community-based HIV Testing in Southern China: Implementation and Results from a District-level Campaign","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eHIV remains one of the most significant public health challenges worldwide, especially in low- and middle-income countries. According to the data from the World Health Organization (WHO), [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] it has claimed the lives of 40.4\u0026nbsp;million people [32.9\u0026ndash;51.3 million] to date and continues to spread globally. Alarmingly, some countries with previously declining incidence rates are reporting an increasing trend in new infections. Despite increasing efforts in HIV/AIDS awareness campaigns globally, [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e] public knowledge and understanding of the disease remain insufficient. This gap is often associated with low educational attainment, residence in rural areas, and a lack of educational initiatives. [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e] Global evidence indicates that in 2020, only 84% of HIV-positive individuals were aware of their status, 87% of them had access to antiretroviral therapy (ART), and 90% of those on ART had their viral loads suppressed. HIV positive individuals being aware of their status can reduce the probabilities of HIV transmission through behavioral change, such as condom use, avoiding sharing needles, or participation in mother-to-child transmission prevention programs. Conversely, those HIV positive individuals who are not aware of their status may experience delayed diagnosis and treatment, lead to higher morality and increased transmission. Knowing one\u0026rsquo;s status is also essential for initiating ART, which offers the benefits ofreducing virus load, promoting immune reconstitution, eliminating opportunistic infections and enjoying a normal life. Five priority populations (men who have sex with men, people who inject drugs, sex workers, transgender people, and individuals in prisons or other closed settings) are disproportionately affected by HIV. These populations and their sexual partners account for 65% of global HIV infections. [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] The Global HIV Prevention Coalition (GPC) also reported that only 44% of sex workers, 28% of men who have sex with men, and 37% of people who inject drugs received two or more HIV prevention services in the past three months. [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] The progress of HIV education and prevention programming is far from reaching the 95%-95%-95% target by 2030 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eOn a global scale, community-based HIV screening has been implemented as a crucial measure for the early detection and treatment of HIV-infected individuals. The widespread use of the campaign has led to the diagnosis of a significant number of previously unidentified HIV-infected individuals, providing them with valuable opportunities for early treatment. The promotion of screening has also enhanced public understanding of HIV prevention and reduced stigma. Screening data serves as vital evidence for developing and implementing HIV prevention and control strategies, playing a significant role in achieving the goal of ending AIDS by 2030. [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] As a result, community-based HIV screening campaign have been implemented in high HIV/AIDS disease burden settings. For example, to identify the optimal methods for maximizing population-level testing coverage, a door-to-door census, multi-disease community health campaign that included HIV testing was launched in rural Kenya and Uganda. Results from this campaign demonstrated a high HIV testing coverage of a hybrid, mobile approach in both countries. [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] To assess factors associated with HIV infection among youth, a Community Health Initiative was also implemented in an urban areas of western Kenya. Their findings highlight the need for HIV prevention programs specially tailored for youth to further reduce new HIV infections in the community. [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] To identify individuals who are unaware of their HIV-positive status and achieve testing saturation, a second study in western Kenya was implemented with a hybrid HIV testing approach in an urban area to describe the uptake of HIV testing and linkage to care and treatment during the program. [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] This community-based HIV testing program successfully identified people who are unaware of their HIV-positive status and achieved testing saturation. [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] However, challenges remain for community-based testing campaigns focusing on universal testing, the uptake of HIV testing and linkage to care and ART among men and young populations in China.\u003c/p\u003e\u003cp\u003eAccording to data from the Chinese Center for Disease Control and Prevention, sexual transmission has become the primary route of HIV infection in China. In recent years, over 95% of reported cases in China have been attributed to sexual transmission. Heterosexual transmission comprises approximately 70%, while transmission among MSM accounts for about 25%. Meanwhile, the number of HIV infections among young Chinese has significantly increased, with an annual growth-rate of newly diagnosed among college students ranging from 30\u0026ndash;50%. One study indicated that in Guangxi, Southern China, 70.7% of young students are infected with HIV through MSM rather than heterosexual contact. [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] The challenge posed by HIV infections among young individuals, particularly transmitted through MSM behavior has emerged as a major obstacle to achieving the goal of ending HIV transmission in China.\u003c/p\u003e\u003cp\u003ePrevious campaigns have successfully identified those who are HIV seropositive and have allowed for timely access to ART services and referral to the National HIV Program (NHP) services. Additionally, those seronegative individuals with high-risk behaviors for HIV infection are referred to a menu of biomedical HIV intervention and prevention tools provided through local NHP or non-government organizations (NGOs). However, population-level testing coverage and the optimal method for extending screening among MSM population continue to be significant challenges. Therefore, our article focuses on a community-based HIV screening campaign carried out in a university communities in southern China. Our results explore the optimal methods to involve younger Chinese in CTC and to demonstrate the results of a population-wide testing campaign with a door-to-door census, public mobilization of HIV testing, and evaluate the uptake of HIV testing and linkage to care and ART during this program. By collecting, organizing, and analyzing data, we examine the implementation, effectiveness, and the challenges of CTC in university communities in China.\u003c/p\u003e"},{"header":"2 Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Study design and settings\u003c/h2\u003e\u003cp\u003eTo identify individuals infected HIV in an earlier stage and those who are unaware of their HIV-positive status, a community-based HIV testing campaign was performed in South Xiuling District, one of the districts in urban Nanning, Southern China, with a population size of 108,148 and four surrounding universities, e.g. Guangxi University, Guangxi Industrial Technologic College, Guangxi College of Finance and Economics, and Nanning Commercial and Trade School. These are communities characterized by large youth populations, dense clusters of surrounding universities, and a rising number of HIV-positive individuals due to MSM transmission.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Study population and data collection methods\u003c/h2\u003e\u003cp\u003eResidents of the eight communities in Xiuling District have participated in CTC. We randomly sampled from the initial population of 108,148 people who aged fifteen and above. Only those with negative HIV tests record before participating in the CTC from January 2023 to December 2023 were considered repeat testing. The urban HIV TDC rate was calculated based on historical positive diagnosis data within the community and newly identified positive diagnoses, fusing on discovery rates by age group and transmission route.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 CTC Implementation Process\u003c/h2\u003e\u003cp\u003eWe used a two-stage sampling approach to identify participants. In the first stage, we randomly selected eight communities, in which a total of 108,148 people participated in the screening. First, population in communities of Xiuling District underwent census enumeration followed by mobile HIV testing services. Using a door-to-door census approach, we conducted public mobilization, voluntary counseling and testing (VCT), collection of blood samples, laboratory testing and confirmation of HIV. All staff participating in blood collection and HIV testing had medical backgrounds and adhered to medical ethics and safety standards, respecting participants' privacy and informed consent throughout the entire process. Staff used disposable equipment for blood collection to ensure the safety and hygiene of sampling. Those with HIV-positive test results were referred to the local CDC for confirmation and initiation of ART treatment. Demographic characteristics of those diagnosed with HIV/AIDS were collected for comparison and analysis (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003e2. 4 Statistical analysis\u003c/h3\u003e\n\u003cp\u003eA generalized additive model was used as a preliminary step using personal demographic characteristics for variable selection. Covariates were removed one by one until a model with minimum Akaike information criterion (AIC) was attained. Chi-square tests were used to assess differences among personal demographic characteristics between those newly testing-positive and those previously positive for HIV. Variables with significant differences (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) were incorporated into a final multivariable logistic regression model to evaluate their impact on the HIV-testing results. Preliminary statistical analysis was performed using R (version 4.4.1), and corrections were analyzed using Stata/MP 17.\u003c/p\u003e"},{"header":"3 Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 Baseline characteristics of the testing-participated adults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrom January 15 to December 8, 2023, 31,954 individuals were eligible for HIV testing services in 8 communities of an urban area. Subsequently, 15,805 (49.5%) accepted testing, of which 5,883 (37.2%) were males, 9,922 (62.8%) were female; 4,214 (26.7%) were aged 60 years or older, and 7,004 (44.3%) were college students. There were statistically significant differences by gender (\u0026chi;\u003csup\u003e2\u003c/sup\u003e=684.81, \u003cem\u003eP\u003c/em\u003e \u0026lt; .001), age-groups (\u0026chi;\u003csup\u003e2\u003c/sup\u003e=71.07, \u003cem\u003eP\u003c/em\u003e \u0026lt; .05) and educational levels (\u0026chi;\u003csup\u003e2\u003c/sup\u003e=30.78, \u003cem\u003eP\u003c/em\u003e \u0026lt; .001). The age of participants ranged from 15 to 101 years old with an average age of 36.51 (36.51 \u0026plusmn; 22.7) years. The majority were 15-24 years old (50.1%, 7,914/15,805), 15,450 (97.8%) were first-time testers (male 37.4%, female 62.6%), and 355 (2.2%) were repeat testers (Table 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Community-based HIV testing results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2.1 Epidemiological characteristics of newly identified HIV cases\u0026nbsp;\u003c/strong\u003eA total of 58 individuals tested positive for HIV during the initial testing in the CTC. Three participants were confirmed negative after a confirmation test. Among the 55 who were confirmed HIV positive, 25 had been diagnosed previously and 30 (0.2%, 30/15805) residents were newly identified as HIV-positive. Among those newly identified HIV cases, 20 were males (20/30, 66.7%) and 10 were females (10/30, 33.3%). Ages of those newly diagnosed ranged from 16 to 91 years old with an average age of 36 (36\u0026plusmn;22.73) years, with the majority in the 25-44 age-group (12/30, 40%). The majority were of Han ethnicity (27/30, 90%), married (12/30, 40%), with a education attainment of junior high school (15/30, 50%). They predominantly acquired the infection through heterosexual (17/30, 56.7%) or 43.3% (13/30) MSM sexual behavior.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2.2 HIV identification among those 15-44\u0026nbsp;\u003c/strong\u003eIn the age-group 15-44, there were a total of 21 (70%, 21/30) individuals newly diagnosed with HIV, including 16 (76.2%, 16/21) males and 5 (23.8%, 5/21) females. The majority were unmarried (16/21, 76.2%), and the main route of infection was MSM behavior (13/21, 61.9%). In the 15-24 age-group, 7 out of 9 individuals were infected through MSM behavior (77.8%), while in the 25-44 age-group, 6 out of 12 were infected through MSM behavior (50%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3\u003c/strong\u003e \u003cstrong\u003eComparison between those newly testing positive HIV individuals and previous HIV diagnosis\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3.1 Demographic characteristics of newly testing positive HIV cases and previously identified HIV/AIDS and the testing discovery coefficients (TDC)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrom January 2015 to 2023 December, there were a total of 440 people living with HIV (PLHIV, including 30 individuals newly identified as HIV positive in the CTC). The TDC (defined as individuals newly diagnosed HIV positive divided by the sum of individuals previously confirmation and those newly identified HIV-positive) was 6.82% (30/440). A total of 410 residents had been previously diagnosed HIV/AIDS (Table 2). Compared to those who were newly identified as HIV positive, those previously identified 332 were males (80.98%, 332/410), with a male discovery coefficient of 5.68% (20/352), and a male prevalence rate of 0.64% (352/55350); 78 were females (78/410, 19.02%), with a female discovery coefficient of 11.36% (10/88), and a female prevalence rate of 0.17% (88/52797). The age-group primarily affected was 25-44 years old (236/410, 57.56%), with the 15-24 age-group having the highest discovery coefficient at 16.07% (9/56); the marital status was predominantly unmarried (242/410, 59.02%); and the main mode of transmission was heterosexual (208/410, 50.73%). Statistical significance was found in age-group (\u0026chi;\u003csup\u003e2\u003c/sup\u003e=9.459, \u003cem\u003eP =\u0026nbsp;\u003c/em\u003e.024) and ethnic groups (\u0026chi;\u003csup\u003e2\u003c/sup\u003e=18.761, \u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u0026lt; .001) when compared to the previous identification. Among the newly discovered HIV-positive cases in CTC, MSM was the predominant route of HIV infection in youth age-group (15-44 years old), accounting for 43.33% (13/30) of the newly identified as HIV positive in CTC (Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3.2\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eART Uptake and viral load\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eVL\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003cstrong\u003eof newly identification as HIV positive\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e83.9% of those previously diagnosed with HIV/AIDS reported receiving ART (344/410). Out of the 30 confirmed HIV positive, 29 (96.7%) initiated ART (one patient died during the course of the study) with a TDF+3TC+EFV regimen (Tenofovir disoproxil + Lamivudine + Efavirenz). Compared to those with a previous diagnosis of HIV/AIDS, there was no statistically significant increase of ART uptake among newly identified as HIV positive (96.7% vs. 83.9%, \u0026chi;\u003csup\u003e2\u003c/sup\u003e =2.61, \u003cem\u003eP\u0026nbsp;\u003c/em\u003e= .40).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAmong those previous diagnosed with HIV/AIDS, the baseline CD4+ T cell count was 373.46 cell/\u0026mu;L (373.46\u0026plusmn;198.79).Among those newly identified as HIV positive individuals, the baseline CD4\u003csup\u003e+\u003c/sup\u003e T cell count was 327.57 cell/\u0026mu;L (327.57\u0026plusmn;135.15). There was no significant difference between those with a previous diagnosis of HIV and those identified at CTC (t = -1.227, \u003cem\u003eP\u0026nbsp;\u003c/em\u003e= .51) (Fig.2 a).\u003c/p\u003e\n\u003cp\u003eThe baseline VL was 100,977.56 copies among those previously diagnosed and was 151,839.91 copies among those newly diagnosed. Compared to those with previous diagnosis, the baseline VL of those newly identified was significant higher (\u0026chi;\u003csup\u003e2\u003c/sup\u003e = 16.033, \u003cem\u003eP\u0026nbsp;\u003c/em\u003e= 6.2\u0026times;10\u003csup\u003e-5\u003c/sup\u003e) (Fig.2 b).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 Multivariate logistic regression analysis of prediction factors impact HIV testing results\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAccording to the Logistic regression analysis results, factors impeding HIV/AIDS are related to male [odds ratio (OR) = 3.372, 95% confidence interval (CI): 1.578-7.721]; 25-44 years old (OR = 3.871, 95% CI: 1.629-6.197), \u0026gt;59 years old (OR = 0.626, 95%CI: 0.269-2.314); Zhuang (OR =1.408, 95% CI:0.427-4.645); junior high school (OR = 1.780, 95% CI) 0.515-6.164) and college degree or above (OR = 0.141, 95% CI: 0.023-0.843) (Fig. 3 and Table 2).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eTo our knowledge, this is the first implementation of an HIV CTC in Southern China, which has long been considered a high transmission risk area among the provinces of China. The CTC provided HIV testing in the urban areas in South Xiuling District, to discover those newly infected with HIV. Those newly identified as HIV positive were then directed to the services of NHP, including HIV care and ART. The CTC has enumerated 50% of the local residents who were eligible for HIV testing accepted testing. after the campaign. Consistent with similar research, considering the HIV incidence, TDC, HIV prevalence, and awareness of HIV status, CTC is recommended as a public health approach that should be expanded to other high HIV risk areas of China as the results of this study show that it served a crucial role in earlier HIV detection, [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] and was a step towards achieving the goal of ending AIDS by 2030. [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eMSM behavior has been increasing as the predominant HIV transmission route among young adults in urban areas in China. The proportion of those infected through MSM transmission is increasing toward the proportion of heterosexual transmission. A number of studies previously found that the predominant HIV-transmission route in Guangxi was injection drug use, [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] which then shifted to heterosexual sexual contact, [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e] Similar to other countries, [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] HIV transmission through MSM behavior has emerged as a public health priority, with an average prevalence of HIV among MSM in China of 5.7% between 2001 and 2018, [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] and in Guangxi, Southern China up to 6.53%. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] HIV transmission risk-factors associated with MSM were age, education background, and occupation, [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] Because of sensitivity, and social stigma, HIV screening uptake in the MSM population is limited. [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e] However, higher sexual risk, young age and being identified as MSM has been positively correlated with HIV positive testing. [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e] Our research confirmed that HIV transmission in newly identification among MSM increased to 61.90% among individuals who were 15\u0026ndash;44 years old. South Xiu Ling district is a community with five universities; more than 7,000 university-students were involved in the CTC; they are young and have a high education background. The characteristics of the majority of participants of the CTC are consistent with MSM in previous studies and may help explain the elevated HIV transmission through MSM in our study. [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] The findings in our study emphasize that MSM college students should be a priority population for HIV prevention and control, [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e] and that HIV/AIDS-related education and prevention should be promoted on campus, such as increasing the uptake of ART within students who HIV are positive, and encouraging condom-use during sex among MSM. [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eOur study found that the majority of CTC participants were those aged 15\u0026ndash;24 years, followed by older people aged\u0026thinsp;\u0026gt;\u0026thinsp;59 years and young adults aged 25\u0026ndash;44 years. This finding may reflect the reality that both young and old in the urban districts are seeking testing. HIV prevention education efforts that have been implemented in Guangxi may have contributed to the promotion of HIV testing uptake. Our findings are consistent with the findings of testing motivation study elsewhere. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/p\u003e\u003cp\u003e97.8% of the participants were first-time testers. Among them, 37.4% were male and 62.6% were female. HIV-testing uptake among males was substantially lower than females. A similar testing gap has been observed in Zambia. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] However, even with a low HIV-testing uptake, the HIV yield among males was substantially higher than females in our study. It suggests that being male in urban areas in Guangxi is one of the independent predictors of HIV infection. The reasons for male less involvement in the testing may be due to their responsibility of work, less trust of the health system, and the social stigma during seeking the testing. For example, research has found that conversations about acceptance of HIV testing may make men feel awkward and this may decrease the willingness of male HIV testing. [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] Building trust, incorporating HIV testing in multiple-diseases testing services, and enabling access to their health care needs are urgently needed to close gaps in HIV testing.\u003c/p\u003e\u003cp\u003eAlthough males produced the majority of newly identification of HIV positive in CTC, an increasing TDC among females was observed. The TDC ratio in male and female was 5.68 : 11.36. this observation may reflect female individuals were missed by traditional testing activities or are in a higher risk of HIV infection recently.\u003c/p\u003e\u003cp\u003eHIV yield was higher among males, 45\u0026ndash;59 of age, Han ethnicity, and a junior high-school education. Considering most participants were first time testers, these findings indicate that these population groups have higher incidence rate than others. Individuals in these groups may be participating in high-risk behaviors for HIV infection such as commercial sex among the elder generations and MSM in young male. Commercial sex in 45\u0026ndash;59 years of male has previously been reported as the highest risk group of HIV transmission in Guangxi, Southern China. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e] CTC was able to identify these groups as priorities for testing. TDC in residents of female, 15\u0026ndash;24 years of age, Han ethnicity, and a high-school education background are higher. These results may also indicate that CTC is more successful at reaching these groups. HIV prevalence in younger generations in Guangxi, Southern China has been increasing in recent years, [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e] and the trend is consistent with the global HIV epidemic. [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/p\u003e\u003cp\u003eART uptake among individuals who have been previously diagnosed with HIV/AIDS is challenging. Only 83.90% of those with a previous diagnosis of HIV/AIDS reported receiving ART in South Xiuling district. However, an increasing trend of initiating ART uptake was observed among those newly identified as HIV positive in CTC with 96.67% of the newly identified initiating ART. High ART uptake was part of HIV testing campaign. [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e] We highlight here that the CTC is an essential tool to reached the UNAIDS testing and treatment targets of 95%.\u003c/p\u003e\u003cp\u003eWe recognize limitations in this study. First, the CTC in 2023 only covered 50% of the population in the community. A staffing shortage necessitated this testing strategy and plans have been developed to cover the remaining population in 2024. Second, it was difficult to document information for those who refused to test for HIV. Third, we could not evaluate virus-suppression status after ART initiation for those newly identification because the ART period has currently not been long enough.\u003c/p\u003e\u003cp\u003eThe CTC identified that the priority groups for HIV testing include males, youth, those 45\u0026ndash;59, MSM, and university communities. The urban areas in Guangxi, Southern China are facing a complex situation, where MSM and heterosexual are facing high HIV transmission. Our findings indicate that community health campaigns are a promising strategy as they are efficient at reaching those who are unaware of their HIV infection status. CTC is an essential tool to achieve the goals of 95% -95%-95% target set by UNAIDS in countries and regions struggling with low HIV testing uptake and ART coverage. Innovative initiatives are needed, with focused attention on access to HIV testing in high-risk groups such as MSM and young men.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has been approved by the Medical Ethics Committee of the Sixth People\u0026apos;s Hospital of Nanning City, with ethics approval number: 2024102301.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData availability statement. All data in this study are available upon request by contact with the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was funded by China National Natural Scientific Fund (NO. 82460390)\u0026nbsp;；Research Initial Fund for Introduced Doctor of Guangxi University of Chinese Medicine (NO.2022BS019).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors\u0026rsquo;contributions: YH and JW collected the data. YL, WH, XL, and ML implemented the survey and collected the samples. JX and ZL made substantial contributions to the conception and design of the work. JH and ZZ contribute to the analysis of the data and literature review as well. JH and YL wrote the draft manuscript. ZZ and EN made major contributions to the interpretation of the results and substantively revised the work/manuscript. All authors have approved the submitted version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe express gratitude to the staff who participated in the CTC at the HIV treatment center and the Southern Xiuling Community health services center.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGlobal health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022-2030. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO\u003c/li\u003e\n\u003cli\u003eAbbaspour A, Jalili Z, Shojaeizadeh D. Study the effect of education based on the theory of planned behavior in the prevention of AIDS among addicts. Iran J Health Educ Health Promot. 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Curr HIV Res, 2019; 17, 85\u0026minus;93.\u003c/li\u003e\n\u003cli\u003eLiu XH, Zhu QY, Meng Q, et al. Characteristics of newly reported HIV/AIDS cases with non-marital or non-commercial heterosexual transmission in Guangxi Zhuang Autonomous Region, 2015-2018. Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Apr 10;41(4):537-541. doi: 10.3760/cma.j.cn112338-20190625-00467. PMID: 32344478 Chinese.\u003c/li\u003e\n\u003cli\u003e．Chen L, His JH, Wu X, et al. Disparities in HIV and syphilis prevalence and risk factors between older male clients with and without steady sex partners in southwestern rural China. BMC Infect Dis. 2017 Apr 12;17(1):269. doi: 10.1186/s12879-017-2367-z.\u003c/li\u003e\n\u003cli\u003eZheng Zhigang, Eric J. Nehl, Geng Wenkui, et al. Impact of antiretroviral therapy on mid-and-long term survival among people living with HIV/AIDS in Guangxi, Southern China - A cohort study. European Journal of Internal Medicine 37 (2017), e40-e43. http://dx.doi.org/10.1016/j.ejim.2016.09.022.\u003c/li\u003e\n\u003cli\u003eGoodreau, SM, Barry, MP, Hamilton, DT, et al. Behavior Change Among HIV-Negative Men Who Have Sex with Men Not Using PrEP in the United States. AIDS BEHAV. 2024; 28 (5): 1766-1780.\u003c/li\u003e\n\u003cli\u003eDong MJ, Peng B, Liu ZF, Ye QN, Liu H, Lu XL, et al. The prevalence of HIV among MSM in China: a large-scale systematic analysis. BMC Infect Dis. 2019;19(1):1000. doi:10.1186/s12879-019-4559-1.\u003c/li\u003e\n\u003cli\u003eGe XM, Yang WM, Zhu QY, Wu XL, Shen ZY, Zhu JH, et al Epidemiological characteristics of HIV/AIDS in Guangxi Zhuang Autonomous Region, 2010-2017. Chin J Epidemiol. 2019;40(3):315\u0026ndash;21. doi: 10.3760/cma.j.issn.0254-6450.2019.03.011.\u003c/li\u003e\n\u003cli\u003eWenxuan Hou, He Jiang, Qiuying Zhu, Jinghua Huang, Jianjun Li, Xiuling Wu, et al. Characteristics of Migration Among HIV-Positive MSM \u0026mdash; Guangxi Zhuang Autonomous Region, China, 2005\u0026ndash;2021. China CDC Wkly. 2023 Mar 31; 5(13): 287\u0026ndash;291. doi: 10.46234/ccdcw2023.052.\u003c/li\u003e\n\u003cli\u003eCheng, W, Friedman, M, Egan, J, et al. HIV-testing patterns and psycho-social factors associated with frequency of testing by men who have sex with men: implication for scaling up HIV testing in China LANCET. 2017; 390 S45.\u003c/li\u003e\n\u003cli\u003eEngstrom, T, Waller, M, Mullens, AB, et al. STI and HIV testing: examining factors that influence uptake among domestic Australian-born, domestic overseas-born and international tertiary students studying in Australia. BMC Public Health. 2023; 23 (1): 505.\u003c/li\u003e\n\u003cli\u003eWohlfeiler D. Structural and environmental HIV prevention for gayand bisexual men. AIDS 2000;14 Suppl 1:S52-6. http://dx.doi.org/10. 1097/00002030-200006001-00008.\u003c/li\u003e\n\u003cli\u003eKobrak P, Remien RH, Myers JE, Salcuni P, Edelstein Z, Tsoi B, et al. Motivations and barriers to routine HIV testing among men who have sex with men in New York City. AIDS Behav 2022;26(11):3563 \u0026minus; 75. http://dx.doi.org/10.1007/s10461-022-03679-5.\u003c/li\u003e\n\u003cli\u003eKabiru CW, Beguy D, Crichton J, Zulu EM. HIV/AIDS among youth in urban informal (slum) settlements in Kenya: what are the correlates and motivations for HIV testing? BMC Pub Health. 2011;11:685.\u003c/li\u003e\n\u003cli\u003eZambia Statistics Agency, Zambia Ministry of Health, ICF. Zambia Demographic and Health Survey 2018 [Internet]. Lusaka, Zambia; Rockville, MD: Zambia Statistics Agency, Ministry of Health, and ICF; 2019. https://dhsprogram.com/pubs/pdf/FR361/FR361.pdf.\u003c/li\u003e\n\u003cli\u003eFleming, PJ, Colvin, C, Peacock, D, et al. What role can gender-transformative programming for men play in increasing men\u0026apos;s HIV testing and engagement in HIV care and treatment in South Africa? CULT HEALTH SEX. 2016; 18 (11): 1251-64.\u003c/li\u003e\n\u003cli\u003eTong Luo, Fei Zhang, Huayue Liang, Dee Yu, Ping Cen, Shanmei Zhong, et al. Men with a history of commercial heterosexual contact play essential roles in the transmission of HIV-1 CRF55_01B from men who have sex with men to the general population in Guangxi, China. Front Cell Infect Microbiol. 2024 Aug 23:14:1391215. doi: 10.3389/fcimb.2024.1391215.\u003c/li\u003e\n\u003cli\u003eZheng Z, Li Y, Jiang Y, Liang X, Qin S, Nehl EJ. Population HIV transmission risk for serodiscordant couples in Guangxi, Southern China: A cohort study. Medicine (Baltimore). 2018 Sep;97(36):e12077. doi: 10.1097/MD.0000000000012077.\u003c/li\u003e\n\u003cli\u003eLiu, H, Zhu, Q, Zhang, L, et al. HIV-Related Knowledge, Attitude, and Practices Research Among College Students - Six Chinese Cities, 2021. China CDC Wkly. 2022; 4 (47): 1043-1050.\u003c/li\u003e\n\u003cli\u003eSlogrove, AL, Mahy, M, Armstrong, A, et al. Living and dying to be counted: What we know about the epidemiology of the global adolescent HIV epidemic. J Int AIDS Soc. 2017; 20 (Suppl 3): 21520.\u003c/li\u003e\n\u003cli\u003eNeuman, M, Fielding, KL, Ayles, H, et al. ART initiations following community-based distribution of HIV self-tests: meta-analysis and meta-regression of STAR Initiative data. BMJ Glob Health. 2021; 6 (Suppl 4).\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"633\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" style=\"width: 633px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 1 .\u003c/strong\u003eDemographic characteristics of participants in the CTC\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 178px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 284px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eParticipants\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eN=15805\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 178px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 133px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ec\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003evalues\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e684.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt; .001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e5883\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e37.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e9922\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e62.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e71.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt; .05\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003e15-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e7914\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003e50.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003e25-44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e2726\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003e17.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003e45-59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e951\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003e6.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003e\u0026gt;59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e4214\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003e26.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eNationality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eHan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 133px;\"\u003e\n \u003cp\u003e13526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e85.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eZhuang\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 133px;\"\u003e\n \u003cp\u003e2116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e13.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eOther Ethnic Groups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 133px;\"\u003e\n \u003cp\u003e163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e1.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e2.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.281\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e9219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e58.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e5184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e32.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eDivorced or widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e1189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e7.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eUnclear\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e1.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eEducation degree\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e30.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt; .001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003ePrimary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 133px;\"\u003e\n \u003cp\u003e3176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 151px;\"\u003e\n \u003cp\u003e20.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eJunior high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 133px;\"\u003e\n \u003cp\u003e4147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 151px;\"\u003e\n \u003cp\u003e26.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 133px;\"\u003e\n \u003cp\u003e1478\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 151px;\"\u003e\n \u003cp\u003e9.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 178px;\"\u003e\n \u003cp\u003eCollege and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 133px;\"\u003e\n \u003cp\u003e7004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 151px;\"\u003e\n \u003cp\u003e44.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 170px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"114%\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"14\" valign=\"top\" style=\"width: 99.8808%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTable 2 .\u003c/strong\u003eFactors related to the HIV positive among newly identification and previous diagnoses\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAccepted HIV testing\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eN=15805\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNewly identification\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eN=30\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 18px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrevious diagnosis\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003eN=410\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHIV yield\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTDC\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"bottom\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ec\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003evalue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest positive\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProportion (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTest positive\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e（\u003c/strong\u003e\u003cstrong\u003en\u003c/strong\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eProportion (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ec\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003evalue\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e3.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e27.67**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e5883\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e66.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e332\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e80.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e9922\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e33.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e19.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e11.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e8.05\u003csup\u003ea\u003c/sup\u003e*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e87.17**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e15-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e7914\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e30.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e11.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e25-44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e2726\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e40.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e236\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e57.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e4.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e45-59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e951\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e20.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e17.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e7.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003e\u0026gt;59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e4214\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e10.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e13.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eNationality\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e18.76**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e15.61**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eHan\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e13526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e90.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e204\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e49.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e11.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eZhuang\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e2116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e10.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e186\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e45.26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eOther Ethnics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e5.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eMarital status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e2.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e3.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e9219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e53.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e242\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e59.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e6.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e5184\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e40.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e113\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e27.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e9.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eDivorced or widowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e1189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e6.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e13.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eUnknown\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e213\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eEducation Degree\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e6.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e9.35*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003ePrimary school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e1478\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e10.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e12.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e5.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eJunior high school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e4147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e50.00\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e201\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e49.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e6.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eHigh school\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e3176\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e33.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e17.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e12.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eCollege and above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e7004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e6.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e21.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eRoute of infection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e2.73\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eHomosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e43.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e46.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e6.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eHeterosexual\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e56.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e208\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e50.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e7.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eInject drug users\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e2.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 17px;\"\u003e\n \u003cp\u003eUnknown/other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 11px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 9px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 99.8808%;\" colspan=\"14\"\u003e\n \u003cp\u003e\u0026nbsp;TDC= newly diagnosed HIV positive / (previously confirmed + newly diagnosed HIV positive) *100%\u003c/p\u003e\n \u003cp\u003eHIV yield= Number of new HIV diagnoses/number of people tested (N)*100%\u003c/p\u003e\n \u003cp\u003e*\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u0026lt; .05, **\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u0026lt;.01, ***\u003cem\u003eP\u0026nbsp;\u003c/em\u003e\u0026lt;.001; a denotes fisher\u0026apos;s exact test.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"HIV, community-based testing, MSM, young adults, testing discovery coefficients","lastPublishedDoi":"10.21203/rs.3.rs-7119195/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7119195/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eCommunity-based testing campaigns (CTC) are critical for HIV prevention and treatment, particularly in regions like Southern China where targeted interventions are needed to address transmission dynamics and improve care access. Using data collected during the implementation of a CTC, we aim to evaluate antiretroviral therapy (ART) uptake, identify priority groups for treatment and prevention, discover factors associated with testing positive for Human immunodeficiency virus (HIV), and evaluate potential transmission-route changes among youth participants.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eTesting discovery coefficients (TDC) of HIV-infected individuals and cross-stratifications were calculated among different demographic groups. The proportion of patients who were aware of their HIV infection status, and ART coverage were recorded. Multivariate logistic regression analysis was used to identify the factors which impacted HIV testing positively, and a random forest plot was used to visualize the predictive factors.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003e15,805 people tested for HIV and 30 individuals were identified as newly HIV positive. The testing positive rate was 19/10,000 and the TDC was 6.8% (30/440). The TDC among females was 11.4% (10/88). The TDC among people aged 15\u0026ndash;24 was the highest, accounting for 16.1% (9/56). Among the newly HIV positive, those 15\u0026ndash;44 years old were primarily infected through men having sex with men (MSM) contact, accounting for 43.3% (13/30) of the new identifications. The proportion of new patients receiving ART after screening was 96.7% (29/30). Predictors of testing positive were being male (OR\u0026thinsp;=\u0026thinsp;3.372, 95%CI: 1.578\u0026ndash;7.211).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eMSM behavior was identified as the main transmission route among those newly infected with HIV in urban Nanning, Southern China. CTC is an effective strategy, leading to a higher yield of HIV and acquired immune deficiency syndrome (AIDS) diagnoses, particularly for female and younger participants. CTC also improved ART uptake among those newly identified as being HIV positive.\u003c/p\u003e","manuscriptTitle":"Community-based HIV Testing in Southern China: Implementation and Results from a District-level Campaign","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-17 14:19:04","doi":"10.21203/rs.3.rs-7119195/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"282373028829691365795040150269706516538","date":"2025-08-24T00:02:57+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-22T07:21:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"294052586375725835542719976762021267995","date":"2025-08-20T12:20:33+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-08T18:58:10+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-18T08:18:33+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-15T10:03:52+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-15T10:01:49+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Infectious Diseases","date":"2025-07-14T09:03:24+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-infectious-diseases","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"infd","sideBox":"Learn more about [BMC Infectious Diseases](http://bmcinfectdis.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/infd","title":"BMC Infectious Diseases","twitterHandle":"#bmcinfectdis","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6efd0192-1b59-433c-81f9-d8f49d2fdd44","owner":[],"postedDate":"August 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-08-17T14:19:04+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-17 14:19:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7119195","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7119195","identity":"rs-7119195","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}