Characteristics of HIV infection diagnosis and treatment care continuum in Wenzhou, Zhejiang, 2019

  Objective  To analyze the detection rate, previous CD4 detection rate, retention rate, registered antiviral therapy (ART) rate, ART maintenance rate, viral load suppression rate and related factors in HIV infection diagnosis and treatment care continuum in Wenzhou of Zhejiang province in 2019, and provide a insights into precise control of AIDS.

  Methods  The case information of people living with human immunodeficiency virus/acquired immunodeficiency syndrome (PLWHA) in Wenzhou were collected, and the multivariate logistic regression model was used to analyze the related factors.

  Results  By the end of 2019, a total of 5 750 PLWHA (5 078–6 473) had been estimated to live in Wenzhou, and the detection rate was 76.2% (67.7%–86.2%). Compared with the previous chain in the HIV infection diagnosis and treatment, the previous CD4 detection rate, retention rate and registered ART rate were 99.1%, 97.2%, and 98.9%, respectively. The ART maintenance rate was 91.5%, and the viral load suppression rate was 95.9%. Multivariate logistic regression analysis showed that PLWHA in correctional places were more likely to loss retention in each chain, and the ORs were 0.23 (95% CI: 0.08–0.64), 0.32 (95% CI: 0.17–0.62), 0.33 (95% CI: 0.18–0.60), 0.33 (95% CI: 0.20–0.54) and 0.49 (95% CI: 0.31–0.78), respectively. Marriage/cohabitating was a protective factor for the retention in each chain, and the ORs were 4.45 (95% CI: 1.65–12.04), 2.50 (95% CI: 1.51–4.15), 2.29 (95% CI: 1.47–3.56), 2.49 (95% CI: 1.76–3.51) and 1.69 (95% CI: 1.29–2.22), respectively. The education levels of senior high school, technical secondary school and college or above were the protective factors for virus load suppression, and the ORs were 1.32 (95% CI: 1.05–1.66), 1.51(95% CI: 1.11–2.06) and 1.55 (95% CI: 1.12–2.15), respectively.

  Conclusion  In 2019, the weak chain in HIV infection diagnosis and treatment in Wenzhou was the disease detection. It is necessary to strengthen the implementation of HIV testing strategies and measures and improve the willingness and service accessibility of high-risk and key groups for HIV testing.