[Survival Status and Its Influencing Factors among HIV-infected Individuals During Different Confirmation Periods in Henan Province, 1995-2023].

Objective: To analyze the survival status and influencing factors among HIV-infected individuals in Henan Province during different confirmation periods from 1995 to 2023, and to provide a scientific basis for optimizing the "early detection, early treatment" strategy. Methods: The data were derived from the Chinese Information System for Disease Control and Prevention. HIV-infected individuals was divided into four periods based on confirmation period: 1995-2007, 2008-2013, 2014-2016, and 2017-2023. A retrospective cohort study was conducted. The life table method was used to calculate survival probability, the Kaplan-Meier method was used to estimate median survival time and to draw the survival curve; the log-rank test was used to compare differences between groups, and the Cox proportional hazards regression model was used to analyze the influencing factors of survival. Results: Among the 109 520 HIV-infected individuals, the all-cause mortality density was 3.83/100 person-years, the average survival time was 18.30 years, with a median of 22.57 years; the cumulative survival probabilities at 1, 5, 10, 20, and 30 years were 88.23%, 76.81%, 67.68%, 53.35%, and 40.99% respectively; the survival time of those who received antiretroviral therapy (ART) (27.22 years) was significantly more than that of those who did not receive ART (0.75 years, χ2=61 676.44, P<0.001). Multivariate Cox regression showed that male (aHR=1.31, 95%CI: 1.28-1.34), ≥45 years old (aHR=1.67, 95%CI: 1.48-1.88 for 45-59 years old; aHR=2.82, 95%CI: 2.49-3.19 for ≥60 years old), farmer or migrant worker (aHR=1.43, 95%CI: 1.38-1.48), blood transmission (aHR=1.19, 95%CI: 1.16-1.23), no CD4+ T lymphocytes (CD4) counts (aHR=3.49, 95%CI: 3.37-3.61), not receiving ART (aHR=5.22, 95%CI: 5.07-5.38) were risk factors for survival. The mortality risk of married individuals (aHR=0.85, 95%CI: 0.82-0.89) or divorced/widowed individuals (aHR=0.88, 95%CI: 0.84-0.91) was lower than that of unmarried individuals, and having junior high school (aHR=0.90, 95%CI: 0.88-0.93) or senior high school education (aHR=0.66, 95%CI: 0.63-0.69) was associated with lower mortality risk relative to primary school education. The detailed causes of death were mainly cardiovascular and cerebrovascular diseases (23.32%) and malignant tumors (13.04%). Conclusions: With the continuous optimization and popularization of ART strategies, the long-term survival status among HIV-infected individuals in Henan Province has significantly improved from 1995 to 2023. It is necessary to strengthen early detection and early treatment, focus on key populations such as the elderly, farmers, and migrant workers, promote the co-management of HIV infection and chronic non-communicable diseases like cardiovascular and cerebrovascular diseases, and further improve the quality of life.