Objective  To understand the characteristics and trends of HIV infection in general population in Liangshan prefecture of Sichuan province by analyzing the results of local premarital HIV screening results during 2014−2020.

  Methods  The premarital HIV screening data in 12 counties in Liangshan during 2015−2020 were collected for the analysis on the socio-demographic characteristics, transmission route and contact history related to risk behaviors of HIV tested positive individuals.

  Results  During 2014−2020, the premarital HIV positive rate in men was higher than that in women; The HIV positive rate fluctuated between 1.49% and 1.99% in men and increased from 0.89% in 2014 to 1.34% in 2020 in women. The HIV positive rate in different areas varied greatly; The HIV positive people were mainly men, and the sex ratio of HIV positive men and HIV positive women decreased from 2.08 in 2014 to 1.36 in 2020; The age of HIV positive individuals ranged from 25 to 39 years, and the proportion of those aged less than 40 years decreased. The HIV positive individuals were mainly in ethnic group of Yi, accounting for 95.49%. The HIV positive individuals were mainly illiterate. The proportion of heterosexual transmission increased from 46.50% in 2014 to 62.98% in 2020, while the proportion of injecting drug use decreased from 53.39% in 2014 to 37.02% in 2020; Men accounted for 86.53% of HIV positive people infected by injecting drug use, and there were more women infected by heterosexual transmission, accounting for 58.61%; Heterosexual transmission was mainly caused by non-marital and non-commercial sexual contacts with the proportion increasing from 48.04% in 2014 to 72.87% in 2020, followed by marital sexual contact.

  Conclusion  The prevalence of HIV/AIDS in the general population of Liangshan was high. The early HIV transmission pattern was characterized by injection drug use. Since the control of injecting drug use related HIV epidemic, the HIV transmission pattern has gradually changed from injection drug use to heterosexual contact, especially non-marital non-commercial heterosexual contact, across Liangshan. It is necessary to take targeted health education and intervention measures in Yi ethnic group.