{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T21:36:29Z","timestamp":1793223389734,"version":"4.5.0"},"reference-count":19,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T00:00:00Z","timestamp":1671148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001547","name":"China Medical Board","doi-asserted-by":"publisher","award":["20-391"],"award-info":[{"award-number":["20-391"]}],"id":[{"id":"10.13039\/100001547","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001547","name":"China Medical Board","doi-asserted-by":"publisher","award":["71904171"],"award-info":[{"award-number":["71904171"]}],"id":[{"id":"10.13039\/100001547","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001547","name":"China Medical Board","doi-asserted-by":"publisher","award":["20201203B203"],"award-info":[{"award-number":["20201203B203"]}],"id":[{"id":"10.13039\/100001547","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001547","name":"China Medical Board","doi-asserted-by":"publisher","award":["2020KY777"],"award-info":[{"award-number":["2020KY777"]}],"id":[{"id":"10.13039\/100001547","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["20-391"],"award-info":[{"award-number":["20-391"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["71904171"],"award-info":[{"award-number":["71904171"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["20201203B203"],"award-info":[{"award-number":["20201203B203"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2020KY777"],"award-info":[{"award-number":["2020KY777"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Hangzhou Agricultural and Social Development Scientific Research General Project","award":["20-391"],"award-info":[{"award-number":["20-391"]}]},{"name":"Hangzhou Agricultural and Social Development Scientific Research General Project","award":["71904171"],"award-info":[{"award-number":["71904171"]}]},{"name":"Hangzhou Agricultural and Social Development Scientific Research General Project","award":["20201203B203"],"award-info":[{"award-number":["20201203B203"]}]},{"name":"Hangzhou Agricultural and Social Development Scientific Research General Project","award":["2020KY777"],"award-info":[{"award-number":["2020KY777"]}]},{"name":"Zhejiang Medical Health Science and Technology Project","award":["20-391"],"award-info":[{"award-number":["20-391"]}]},{"name":"Zhejiang Medical Health Science and Technology Project","award":["71904171"],"award-info":[{"award-number":["71904171"]}]},{"name":"Zhejiang Medical Health Science and Technology Project","award":["20201203B203"],"award-info":[{"award-number":["20201203B203"]}]},{"name":"Zhejiang Medical Health Science and Technology Project","award":["2020KY777"],"award-info":[{"award-number":["2020KY777"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Insufficient HIV detection and late presentation to antiretroviral therapy (ART) pose significant public health challenges. In China, universal access to HIV testing is available now. Under this background, we aim to analyze the trends of HIV detection and the prevalence of delayed HIV diagnosis (DHD) in order to provide evidence for HIV prevention and treatment in China. Methods: Data of HIV tests in Hangzhou city between 2007 and 2018 were collected from the Chinese National HIV\/AIDS Comprehensive Response Information Management System (CRIMS). Descriptive statistics were used to describe the characteristics of HIV testing and detection and the prevalence of DHD among newly diagnosed HIV cases. Non-parametric tests were employed to examine the prevalence of DHD among newly diagnosed HIV cases. Moreover, logistic regression models were employed to explore the influencing factors of DHD. Results: Testing rates doubled from 14.1% in 2007\u20132010 to 28.2% in 2016\u20132018. The total positive rate of HIV tests was 5.3 per 10,000. Preoperative testing was the predominant pathway for HIV tests, accounting for 41.9%, followed by testing for health screening, maternal examination and other patients, accounting for 18.4%, 13.2% and 11.8%, respectively. Meanwhile, the predominant pathway for HIV case detection was also preoperative testing, accounting for 29.1%, followed by testing for other patients, testing at STD clinics and VCT, with the proportions of 18.8%, 15.8% and 13.6%, respectively. MSM (men who have sex with men) contact was the main transmission route, accounting for 55.3%, followed by heterosexual contact, accounting for 41.6%. Overall, DHD occurred in 29.0% of the newly diagnosed cases, and this rate had not improved over the years. A higher prevalence of DHD was found in those diagnosed through a pre-test for receiving blood\/products [OR (95%CI): 5.42(2.95\u20139.97)], detection of other patients [OR (95%CI): 2.08(1.64\u20132.63)], preoperative testing [OR (95%CI): 1.83(1.44\u20132.32)] and spouse or sexual partner testing in positive person [OR (95%CI): 1.93(1.34\u20132.78)] compared with those diagnosed at a VCT clinic. Heterosexuals [OR (95%CI): 1.20(1.06\u20131.36)] had a higher risk of DHD than MSM. Diagnosis at a CDC [OR (95%CI): 0.68(0.55\u20130.83)] and community health centers [OR (95%CI): 0.54(0.39\u20130.75)] had a lower risk of DHD than in hospitals. Older age, males, being single\/divorced or widowed and floating population were also associated with DHD. Conclusions: In China, DHD had not improved in the last 10 years, although HIV testing had been expanded. Therefore, it is important for continued efforts to promote early diagnosis of HIV to prevent transmission, morbidity and early mortality in HIV infection.<\/jats:p>","DOI":"10.3390\/ijerph192416917","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T03:55:39Z","timestamp":1671162939000},"page":"16917","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["HIV Detection and Delayed Diagnosis: A Time Series Analysis in China"],"prefix":"10.3390","volume":"19","author":[{"given":"Junfang","family":"Chen","sequence":"first","affiliation":[{"name":"Hangzhou Center for Disease Control and Prevention, Hangzhou 310021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junfang","family":"Xu","sequence":"additional","affiliation":[{"name":"Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China"},{"name":"Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Luo","sequence":"additional","affiliation":[{"name":"Shenzhen Pingshan District Center for Disease Control and Prevention, Shenzhen 518118, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,16]]},"reference":[{"key":"ref_1","first-page":"5","article-title":"Progress Towards the 90-90-90 Targets for Controlling HIV-China, 2018","volume":"1","author":"Zhao","year":"2019","journal-title":"CCDC Wkly."},{"key":"ref_2","unstructured":"Centers for Disease Control and Prevention (2018, January 09). 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