1990—2019年中国HIV/AIDS发病和死亡趋势及其年龄-时期-队列分析

目的 分析1990—2019年中国HIV/AIDS发病率和死亡率趋势及其年龄-时期-队列效应，为我国HIV/AIDS防治策略提供依据。方法 获取GBD 2019关于中国HIV/AIDS发病率和死亡率的数据，采用Joinpoint回归模型进行时间趋势分析，计算标化发病率和死亡率的年度变化百分比(APC)和平均年度变化百分比(AAPC)。运用年龄-时期-队列(APC)模型探讨影响中国HIV/AIDS发病率及死亡率风险的年龄效应、时期效应以及出生队列效应。结果 1990—2019年，中国HIV/AIDS男性疾病负担高于女性。标化发病率呈现先上升后下降的趋势(AAPC为3.28%),2006—2014年开始下降(APC为-8.46%),标化死亡率呈现上升趋势(AAPC为7.06%)。青壮年人群(15～19岁组至25～29岁组)和老年人群(65～69岁组至75～79岁组)发病率的年龄效应呈现上升趋势，男性最大RR为2.23,女性为1.84,65～69岁组(RR男性为1.23,女性为1.22)之前死亡率的年龄效应变化趋势男女一致，之后男性上升，女性下降。发病率时期效应先上升后下降，转折点为2004...

Incidence and mortality trends and age-period-cohort of HIV/AIDS in China, 1900-2019

Objective To analyze the trend and the age-period-cohort effect of HIV/AIDS incidence and mortality in China from 1990 to 2019, so as to provide theoretical support for HIV/AIDS prevention and control strategies in China.Methods The data of the incidence and mortality of HIV/AIDS in China in GBD 2019 were collected. The time trend analysis was performed using Joinpoint regression model to calculate annual percentage change(APC)and average annual percentage change(AAPC)of standardized incidence and mortality. The age-period-cohort(APC)model was used to investigate the effects of age, period and birth cohort on HIV/AIDS incidence and mortality in China.Results From 1990 to 2019, the burden of HIV/AIDS in men was higher than which in women in China. The standardized incidence increased firstly and then decreased(AAPC was 3.28%), and decreased from 2006 to 2014(APC was -8.46%), while the standardized mortality rate increased(AAPC was 7.06%). The age-effect of young and middle-aged population(15-19 years old to 25-29 years old)and elderly population(65-69 years old to 75-79 years old)showed an increasing trend in incidence, with the maximum RR of 2.23 for men and 1.84 for women. The age-effect trend of mortality was consistent between men and women before 65-69 years old(RR of 1.23 for men and 1.22 for women), but then increased in men and decreased in women. The period effect of incidence increased firstly and then decreased, and the turning point was in 2004(RR was 0.68 for men and 2.11 for women). The period effect of mortality increased with time. As for cohort effect, the trend of morbidity was fluctuant but the trend of mortality was stable.Conclusion From 1990 to 2019, the prevalence of HIV/AIDS in China has been controlled, but the mortality rate was on the rise. There are obvious gender and age differences in both morbidity and mortality. Targeted measures need to be formulated to effectively protect people exposed to HIV/AIDS risk, and more attention needs to be paid to young adults and the elderly.