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Background <p>The population of people living with HIV (PLHIV) aged ≥ 50 years is rapidly increasing worldwide, accompanied by a growing burden of chronic comorbidities. This study explored multimorbidity patterns and associated factors among older PLHIV according to HIV transmission category in China.</p> Methods <p>A cross-sectional survey was conducted among PLHIV aged ≥ 50 years receiving antiretroviral therapy (ART) in Chongqing and Jiamusi, China, between April and September 2023. Demographic characteristics, HIV-related factors, and 16 predefined comorbidities were collected. Logistic regression, association rule mining, and network analysis were used to identify factors associated with multimorbidity and characterize comorbidity clustering patterns.</p> Results <p>Among 504 participants, 205 (40.7%) reported male-to-male transmission and 299 (59.3%) reported heterosexual transmission. The median age was 62 years (IQR: 54–70), and 62.9% had at least one chronic comorbidity. Multimorbidity was more prevalent in heterosexual transmission cases (69.6% vs. 53.2%, <i>P</i> = 0.002). Metabolic and cardio-cerebrovascular diseases were the most prevalent comorbidities. Network analysis showed that syphilis and opportunistic infections were more central among individuals reporting male-to-male transmission, whereas dyslipidemia and cardio-cerebrovascular diseases occupied central positions among those reporting heterosexual transmission. Older age and higher healthcare burden were associated with multimorbidity among individuals reporting male-to-male transmission. Among those reporting heterosexual transmission, longer duration since diagnosis and lower CD4 cell counts were associated with multimorbidity.</p> Conclusions <p>Multimorbidity is common among older PLHIV and shows distinct clustering patterns and associated factors across transmission categories. These findings highlight the heterogeneity of comorbidity profiles in ageing HIV populations and support the need for integrated, patient-centered care.</p>

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Multimorbidity patterns and associated factors among ageing people living with HIV by transmission route in two cities of China

  • 期刊论文

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  • 发表日期：

    2026年7月31日

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  • Qihang Wang,
  • Jinrui Zhang,
  • Haitao Bi,
  • Liying Mu,
  • Abduwaris Wubulkasim,
  • Fangfang Chen,
  • Jingmin Nie,
  • Houlin Tang

摘要

Background

The population of people living with HIV (PLHIV) aged ≥ 50 years is rapidly increasing worldwide, accompanied by a growing burden of chronic comorbidities. This study explored multimorbidity patterns and associated factors among older PLHIV according to HIV transmission category in China.

Methods

A cross-sectional survey was conducted among PLHIV aged ≥ 50 years receiving antiretroviral therapy (ART) in Chongqing and Jiamusi, China, between April and September 2023. Demographic characteristics, HIV-related factors, and 16 predefined comorbidities were collected. Logistic regression, association rule mining, and network analysis were used to identify factors associated with multimorbidity and characterize comorbidity clustering patterns.

Results

Among 504 participants, 205 (40.7%) reported male-to-male transmission and 299 (59.3%) reported heterosexual transmission. The median age was 62 years (IQR: 54–70), and 62.9% had at least one chronic comorbidity. Multimorbidity was more prevalent in heterosexual transmission cases (69.6% vs. 53.2%, P = 0.002). Metabolic and cardio-cerebrovascular diseases were the most prevalent comorbidities. Network analysis showed that syphilis and opportunistic infections were more central among individuals reporting male-to-male transmission, whereas dyslipidemia and cardio-cerebrovascular diseases occupied central positions among those reporting heterosexual transmission. Older age and higher healthcare burden were associated with multimorbidity among individuals reporting male-to-male transmission. Among those reporting heterosexual transmission, longer duration since diagnosis and lower CD4 cell counts were associated with multimorbidity.

Conclusions

Multimorbidity is common among older PLHIV and shows distinct clustering patterns and associated factors across transmission categories. These findings highlight the heterogeneity of comorbidity profiles in ageing HIV populations and support the need for integrated, patient-centered care.