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Peer-reviewedCC BY 4.0Frontiers in Public Health

Spatial clustering and risk factors for late HIV diagnosis in the Yinzhou, China: a population-based retrospective cohort study

  • Yijin Chen1
  • Wei Yu1
  • Bin Wang2
  • Bingyang Liu1
  • Haibo Jiang3
  • Yi Gu1
  • Lv Lin3
  • Deguang Gong2,4
4 affiliations
  1. 1Ningbo Institute of Innovation for Combined Medicine and Engineering, Ningbo Medical Center Li Huili Hospital
  2. 2Department of Tuberculosis and HIV/AIDS Prevention and Control, Yinzhou District Center for Disease Control and Prevention
  3. 3Department of Tuberculosis and HIV/AIDS Prevention and Control, Ningbo Municipal Center for Disease Control and Prevention
  4. 4Baizhang Subdistrict Community Health Service Center, Yinzhou District
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Abstract

Background: Late HIV diagnosis is a critical challenge for controlling the transmission; if not addressed, it could inevitably slow or reverse current progress toward the UNAIDS 95-95-95 targets by 2030.

Methods: We conduct a retrospective study of a full registry of 1404 HIV cases in Yinzhou District (2001–2025), China. Adjusted relative ratio (aRR), posterior relative ratio (RR), Global Moran's I index, and adjusted hazard ratios (aHR) of late HIV diagnosis were calculated using Poisson's regression analysis, subgroup analysis, spatial autocorrelation analysis, and Cox regression, respectively.

Results: The proportion of late HIV diagnosis was 76.4% in Yinzhou. Older age (aRR = 1.003, 95%CI: 1.001–1.006) at HIV diagnosis was significantly associated with a higher risk of late diagnosis. Patients who tested voluntarily (aRR = 0.918, 95%CI: 0.849–0.993) and living in the northwest (aRR = 0.933, 95%CI: 0.876–0.994) were associated with a lower risk. The northwest was a cold spot, and the central and southeast areas were hotspots for late HIV diagnosis (global Moran's I = 0.65, p < 0.001). Patients aged 60 and over and tested non-voluntarily was identified as a priority subgroup (posterior RR = 1.097, 95%PI: 1.013–1.174). Late presenters had a higher hazard of death than non-late presenters (aHR = 3.03, 95%CI: 1.04–8.84).

Conclusion: We identified a priority subgroup at high absolute risk and a hotspot for late HIV diagnosis in Yinzhou. This finding provides evidence for developing targeted intervention strategies.

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Cite

BibTeXRIS
BibTeX
@article{chen2026spatial,
  title = {{Spatial clustering and risk factors for late HIV diagnosis in the Yinzhou, China: a population-based retrospective cohort study}},
  author = {Yijin Chen and Wei Yu and Bin Wang and Bingyang Liu and Haibo Jiang and Yi Gu and Lv Lin and Deguang Gong},
  journal = {Frontiers in Public Health},
  year = {2026},
  month = oct,
  doi = {10.3389/fpubh.2026.1888278},
  url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1888278/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Spatial clustering and risk factors for late HIV diagnosis in the Yinzhou, China: a population-based retrospective cohort study
AU  - Yijin Chen
AU  - Wei Yu
AU  - Bin Wang
AU  - Bingyang Liu
AU  - Haibo Jiang
AU  - Yi Gu
AU  - Lv Lin
AU  - Deguang Gong
PY  - 2026
DA  - 2026/10/27
JO  - Frontiers in Public Health
DO  - 10.3389/fpubh.2026.1888278
UR  - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1888278/full
AB  - Background: Late HIV diagnosis is a critical challenge for controlling the transmission; if not addressed, it could inevitably slow or reverse current progress toward the UNAIDS 95-95-95 targets by 2030.  Methods: We conduct a retrospective study of a full registry of 1404 HIV cases in Yinzhou District (2001–2025), China. Adjusted relative ratio (aRR), posterior relative ratio (RR), Global Moran's I index, and adjusted hazard ratios (aHR) of late HIV diagnosis were calculated using Poisson's regression analysis, subgroup analysis, spatial autocorrelation analysis, and Cox regression, respectively.  Results: The proportion of late HIV diagnosis was 76.4% in Yinzhou. Older age (aRR = 1.003, 95%CI: 1.001–1.006) at HIV diagnosis was significantly associated with a higher risk of late diagnosis. Patients who tested voluntarily (aRR = 0.918, 95%CI: 0.849–0.993) and living in the northwest (aRR = 0.933, 95%CI: 0.876–0.994) were associated with a lower risk. The northwest was a cold spot, and the central and southeast areas were hotspots for late HIV diagnosis (global Moran's I = 0.65, p < 0.001). Patients aged 60 and over and tested non-voluntarily was identified as a priority subgroup (posterior RR = 1.097, 95%PI: 1.013–1.174). Late presenters had a higher hazard of death than non-late presenters (aHR = 3.03, 95%CI: 1.04–8.84).  Conclusion: We identified a priority subgroup at high absolute risk and a hotspot for late HIV diagnosis in Yinzhou. This finding provides evidence for developing targeted intervention strategies.
SN  - 2296-2565
ER  -