AbstractThis study examined the prevalence of HIV late diagnosis (LD) and identified associated factors with LD among people living with HIV (PLWH). We extracted sociodemographic, epidemiological, and immunological information between 2018 and 2021 in Hunan, China from the HIV/AIDS Comprehensive Response Information Management System of China.

摘要本研究调查了HIV晚期诊断（LD）的患病率，并确定了HIV感染者（PLWH）中LD的相关因素。我们从中国艾滋病毒/艾滋病综合应对信息管理系统中提取了2018年至2021年中国湖南省的社会人口统计学，流行病学和免疫学信息。

The chi-squared test and multivariable logistic regression model were used to identify the factors associated with LD. Among 22,504 PLWH, 14,988 (66.6%) were diagnosed late. PLWH aged 50 and older had a higher proportion of LD (71.2%) than the younger group (60.0%). Older age, being male, Han ethnicity, being registered in Western Hunan, being transferred from health facilities, and being infected through heterosexual intercourse were associated with LD.

卡方检验和多变量逻辑回归模型用于确定与LD相关的因素。在22504例PLWH中，14988例（66.6%）被诊断为晚期。50岁及以上的PLWH的LD比例（71.2%）高于年轻组（60.0%）。年龄较大，男性，汉族，在湘西登记，从卫生机构转移以及通过异性性交感染与LD有关。

Among PLWH younger than 50 years, apart from the factors mentioned above, individuals who had primary school or lower education, were non-student, and were divorced or widowed were more likely to be diagnosed late. Unlike younger PLWH, these factors were not associated with LD in the older group. But regional disparities in LD were more significant among them.

在50岁以下的PLWH中，除上述因素外，小学或更低学历，非学生，离婚或丧偶的人更有可能被诊断为晚期。与年轻的PLWH不同，这些因素与老年组的LD无关。。

LD in PLWH remains a severe issue, especially among older people. The study findings provided valuable insights into designing programs targeting groups at higher risk of LD to reduce its prevalence..

PLWH中的LD仍然是一个严重的问题，尤其是在老年人中。研究结果为设计针对LD高风险人群的计划以降低其患病率提供了宝贵的见解。。

IntroductionBy 2023, 39.9 million people were living with HIV globally1. Since 2010, new HIV infections have declined by 38%, and AIDS-related deaths have dropped by 51%, indicating we were getting closer to the end of the HIV/AIDS epidemic2. The Joint United Nations Programme on HIV/AIDS (UNAIDS) has proposed a goal known as 95-95-95 (95% detection, 95% treatment, 95% viral suppression) for HIV testing and treatment by 20253.

引言到2023年，全球有3990万人感染艾滋病毒1。自2010年以来，新感染艾滋病毒的人数下降了38%，与艾滋病相关的死亡人数下降了51%，这表明我们正在接近艾滋病毒/艾滋病疫情的结束2。联合国艾滋病毒/艾滋病联合规划署（UNAIDS）提出了一个到20253年进行艾滋病毒检测和治疗的目标，即95-95-95（95%检测，95%治疗，95%病毒抑制）。

However, as of 2022, global data showed that testing and treatment had only reached levels of 86-89-93 worldwide2. This means we still have some way to go in achieving UNAIDS’ goals, especially in reaching the first target of 95% of people knowing their infected status.In 2018, UNAIDS launched the campaign “Know Your Status,” which many counties have adopted, leading to expanded HIV testing4.

然而，截至2022年，全球数据显示，检测和治疗在全球范围内仅达到86-89-93的水平2。这意味着我们在实现联合国艾滋病规划署的目标方面还有一段路要走，特别是要达到95%的人知道自己感染状况的第一个目标。2018年，联合国艾滋病规划署发起了“了解你的状况”运动，许多国家都采用了这一运动，从而扩大了艾滋病毒检测范围4。

However, many people living with HIV (PLWH) are still late in being diagnosed, defined as having a low CD4 cell count or showing symptoms of advanced stage (AIDS) at diagnosis5. As early as 2011, the European Late Presenter Consensus working group released a consensus definition of HIV late diagnosis (LD), which aroused researchers’ interest in the severe impacts and prevalence of LD6.

然而，许多艾滋病毒感染者（PLWH）仍未被诊断出来，定义为CD4细胞计数低或在诊断时表现出晚期（艾滋病）症状5。早在2011年，欧洲晚期主持人共识工作组就发布了艾滋病毒晚期诊断（LD）的共识定义，这引起了研究人员对LD6的严重影响和流行的兴趣。

Compared with non-LD, PLWH with LD had a poor quality of life and higher morbidity and mortality rates, leading to higher costs of HIV care7,8. Additionally, the likelihood of HIV transmission might increase during the period of unknown HIV status9. Nevertheless, the proportion of LD in many countries remains high: about 50% in Europe10, followed by 47–55% in Africa11,12, and 34–72% in Asia13.

与非LD相比，患有LD的PLWH的生活质量较差，发病率和死亡率较高，导致HIV护理成本较高7,8。此外，在未知HIV状态期间，HIV传播的可能性可能会增加9。然而，在许多国家，LD的比例仍然很高：欧洲约为50%，其次是非洲的47-55%11,12和亚洲的34-72%13。

Researchers have conducted studies to determine the reasons for and reduce the proportion of LD. Some factors associated with LD that have been identified are age, gender, educational lev.

研究人员进行了研究，以确定LD的原因并降低其比例。已经确定的与LD相关的一些因素是年龄，性别，教育程度。

Data availability

数据可用性

The data that support the findings of this study are not openly available due to reasons of sensitivity and are available from the corresponding author upon reasonable request. Data are located in controlled access data storage at Chinese Center for Disease Control and Prevention.

由于敏感性的原因，支持本研究结果的数据无法公开获得，并且可以根据合理的要求从通讯作者那里获得。数据位于中国疾病预防控制中心的受控访问数据存储中。

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Download referencesAcknowledgementsWe would like to thank all staff who recorded and managed the data in the Hunan Provincial Center for Disease Control and Prevention, China, as well as all participants whose health information was recorded and used anonymously in this study.FundingThis research was supported by the National Natural Science Foundation of China (No.

。资助该研究得到了国家自然科学基金（No。

82273746). This research was also supported by the Hunan Provincial Innovation Foundation for Postgraduate, the Fundamental Research Funds for the Central Universities of Central South University and the Research Foundation of Anhui Medical University (No. 1053320213461, No. 2023ZZTS0604 and No. 2023xkj264).Author informationAuthor notesXinyi Su and Xueyuan Zhong contributed equally to this work.Authors and AffiliationsXiangya Nursing School, Central South University, 172, Tongzipo Road, Changsha, 410013, Hunan, ChinaXinyi Su, Xueyuan Zhong, Honghong Wang, Lu Yu & Yaqin ZhouCenter for Community Research and Evaluation, University of Memphis, Memphis, TN, USAXiangjun ZhangShenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, ChinaYanxiao GaoHunan Provincial Center for Disease Control and Prevention, Changsha, Hunan, ChinaXiaobai Zou, Xi Chen & Jianmei HeAlice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, SingaporeWenru WangSchool of Nursing, Anhui Medical University, Hefei, ChinaJingjing MengAuthorsXinyi SuView author publicationsYou can also search for this author in.

82273746）。这项研究还得到了湖南省研究生创新基金会，中南大学中央大学基础研究基金和安徽医科大学研究基金（编号1053320213461，编号2023ZZTS0604和编号2023xkj264）的支持。作者信息作者注：苏欣怡和钟学远对这项工作做出了同样的贡献。作者和附属机构中南大学湘雅护理学院，长沙桐梓坡路172号，410013，湖南，中国苏欣怡，钟学远，王洪宏，吕宇和周亚琴孟菲斯大学社区研究与评估中心，孟菲斯，田纳西州，美国湘军张深圳中国科学院深圳先进技术研究所，深圳，中国湖南省疾病预防控制中心，湖南长沙，中国小白邹，Xi Chen和Jianmei HeAlice Lee国立大学医学院护理研究中心新加坡，新加坡，新加坡，安徽医科大学护理学院，中国合肥，南京门戈新意苏维作者出版物您也可以在中搜索这位作者。

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PubMed Google ScholarContributionsXinyi Su and Xueyuan Zhong conceived of this study, cleansed and analysed the data, wrote the first draft, and revised the manuscript. Xiangjun Zhang and Yanxiao Gao reviewed the draft and provided critical suggestions, contributing greatly to the quality of our manuscript.

PubMed谷歌学术贡献Sxinyi Su和Xueyuan Zhong构思了这项研究，清理和分析了数据，撰写了初稿，并修改了手稿。张向军和高燕晓审查了草稿并提出了批判性建议，为我们稿件的质量做出了巨大贡献。

Xiaobai Zou and Xi Chen provided clinical data input, output, and verification. Honghong Wang and Wenru Wang provided supervision and funding acquisition, and also reviewed and revised the manuscript. Jingjing Meng and Lu Yu contributed to the data review and analysis. Jianmei He and Yaqin Zhou contributed to the conception of this study, merged and first cleaned the data, communicated with each author, and reviewed and revised every crucial draft.

邹小白和陈曦提供了临床数据的输入，输出和验证。王红红和王文如提供了监督和资金收购，并对稿件进行了审查和修订。。何建梅和周亚琴为这项研究的构想做出了贡献，合并并首先清理了数据，与每位作者进行了沟通，并审查和修订了每一个重要的草案。

All authors reviewed the manuscript and agreed on the final version of the manuscript to be submitted for publication.Corresponding authorsCorrespondence to.

所有作者都审阅了稿件，并同意稿件的最终版本提交出版。通讯作者通讯。

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Reprints and permissionsAbout this articleCite this articleSu, X., Zhong, X., Zhang, X. et al. Unveiling trends in late diagnosis among 22,504 people living with HIV in Hunan, China.

转载和许可本文引用本文Su，X.，Zhong，X.，Zhang，X。等人揭示了中国湖南22504名HIV感染者的晚期诊断趋势。

Sci Rep 14, 23165 (2024). https://doi.org/10.1038/s41598-024-73648-6Download citationReceived: 03 July 2024Accepted: 19 September 2024Published: 05 October 2024DOI: https://doi.org/10.1038/s41598-024-73648-6Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

科学报告142365（2024）。https://doi.org/10.1038/s41598-024-73648-6Download引文接收日期：2024年7月3日接受日期：2024年9月19日发布日期：2024年10月5日OI：https://doi.org/10.1038/s41598-024-73648-6Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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KeywordsHIVAcquired immunodeficiency syndromeLate diagnosisChinaHIV testingPeople living with HIV

关键词SHIV获得性免疫缺陷综合征相关诊断HIV感染者检测

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