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Objective <p>To analyze the epidemiological characteristics and dynamic trends of people living with HIV (PLWH) in Huangshi between 2004 and 2024, thereby providing a scientific basis for the optimization of regional HIV prevention and control strategies.</p> Methods <p>Surveillance data of PLWH from Huangshi during the period 2004–2024 were collected. Descriptive epidemiology methods were employed to examine the temporal distribution, demographic features (including age, sex, marital status), transmission routes, clinical manifestations, and mortality patterns. A Cochrane-Armitage trend test was utilized to assess changes in gender composition, while SPSS 27 was leveraged to establish a time-series model based on exponential smoothing techniques to forecast future mortality counts.</p> Results <p>The number of PLWH in Huangshi exhibited a marked increase post-2009, peaking in 2015, followed by a significant decline from 2020 onward. Key structural shifts were observed: (1) among reported cases, the 51–80 age group accounted for the highest proportion (representing the age composition within the infected population, rather than age-specific incidence in the general population). Male cases showed a pronounced upward trend, whereas female cases demonstrated a gradual decrease. (2) Sexual transmission constituted the predominant mode, accounting for 95.02% of cases, with heterosexual transmission highly concentrated among males aged 51–70 years. (3) The primary opportunistic infections were persistent fever and Pneumocystis pneumonia. Post-2013, mortality rates escalated significantly, yet over one-third of deaths were attributed to causes unrelated to HIV, with cardiovascular diseases and malignancies ranking as major contributors, reflecting a shift toward chronic comorbidity management. (4) Time-series modeling predicted a gradual decline in the estimated number of HIV-related deaths for the years 2025–2028.</p> Conclusion <p>HIV transmission in Huangshi has evolved into a stage characterized by sexual transmission as the primary route, with a notable increase in the disease burden among older adults and males. The focus is now transitioning from HIV-related mortality to the management of chronic comorbidities. Future HIV prevention efforts in the city should adopt comprehensive strategies, including targeted interventions and enhanced surveillance for males-particularly older males-strengthened treatment and prevention measures, and integrated approaches to chronic disease management to address the evolving epidemiological landscape.</p>

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Mortality trends and epidemiological characteristics among people living with HIV in Huangshi, China: a time-series analysis (2004–2024)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月9日

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  • Qingzhi Wang,
  • Haozhen Bai,
  • Li Song,
  • Can Wang,
  • Youyi Xie,
  • Biao Fu,
  • Jumin Xie,
  • Luman Li

摘要

Objective

To analyze the epidemiological characteristics and dynamic trends of people living with HIV (PLWH) in Huangshi between 2004 and 2024, thereby providing a scientific basis for the optimization of regional HIV prevention and control strategies.

Methods

Surveillance data of PLWH from Huangshi during the period 2004–2024 were collected. Descriptive epidemiology methods were employed to examine the temporal distribution, demographic features (including age, sex, marital status), transmission routes, clinical manifestations, and mortality patterns. A Cochrane-Armitage trend test was utilized to assess changes in gender composition, while SPSS 27 was leveraged to establish a time-series model based on exponential smoothing techniques to forecast future mortality counts.

Results

The number of PLWH in Huangshi exhibited a marked increase post-2009, peaking in 2015, followed by a significant decline from 2020 onward. Key structural shifts were observed: (1) among reported cases, the 51–80 age group accounted for the highest proportion (representing the age composition within the infected population, rather than age-specific incidence in the general population). Male cases showed a pronounced upward trend, whereas female cases demonstrated a gradual decrease. (2) Sexual transmission constituted the predominant mode, accounting for 95.02% of cases, with heterosexual transmission highly concentrated among males aged 51–70 years. (3) The primary opportunistic infections were persistent fever and Pneumocystis pneumonia. Post-2013, mortality rates escalated significantly, yet over one-third of deaths were attributed to causes unrelated to HIV, with cardiovascular diseases and malignancies ranking as major contributors, reflecting a shift toward chronic comorbidity management. (4) Time-series modeling predicted a gradual decline in the estimated number of HIV-related deaths for the years 2025–2028.

Conclusion

HIV transmission in Huangshi has evolved into a stage characterized by sexual transmission as the primary route, with a notable increase in the disease burden among older adults and males. The focus is now transitioning from HIV-related mortality to the management of chronic comorbidities. Future HIV prevention efforts in the city should adopt comprehensive strategies, including targeted interventions and enhanced surveillance for males-particularly older males-strengthened treatment and prevention measures, and integrated approaches to chronic disease management to address the evolving epidemiological landscape.