Disease burden of HIV and its behavioral risks among adults aged 20–54 years in China and the Western Pacific Region from 1990 to 2021: an analysis based on the Global Burden of Disease Study 2021
Bibliographic record
Abstract
BACKGROUND: The HIV epidemic remains a significant public health concern among individuals aged 20–54 years. However, comprehensive studies evaluating trends in HIV-related health burdens and associated behavioral risks in China and the Western Pacific Region are limited. METHODS: This study utilizes data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to examine HIV burden indicators—including the age specific rates (ASR) for prevalence (ASPR), incidence (ASIR), mortality (ASMR) and DALYs (ASDR)—among individuals aged 20–54 years in China and the Western Pacific Region from 1990 to 2021. Long-term trends were analyzed using average annual percentage changes (AAPCs), while short-term trends were assessed through annual percentage changes (APCs). Furthermore, trends in HIV-related DALYs associated with behavioral risks were analyzed. RESULTS: In China, ASPR increased by 751.27% (AAPC = 7.19, 95%CI: 7.02–7.35), ASIR by 232.26% (AAPC = 3.8, 95%CI: 2.62–4.99), ASMR by 1535.29% (AAPC = 9.07, 95%CI: 8.51–9.63), and ASDR by 1379.27% (AAPC = 8.72, 95%CI: 8.22–9.23). In the Western Pacific Region, ASPR increased by 1101.91% (AAPC = 8.34, 95%CI: 8.2–8.47), ASIR by 354.24% (AAPC = 4.68, 95%CI: 3.91–5.45), ASMR by 1241.67% (AAPC = 8.56, 95%CI: 8.05–9.08), and ASDR by 1135.86% (AAPC = 8.28, 95%CI: 7.83–8.73). Regarding the HIV-related DALYs rate attributable to behavioral risks, the corresponding rate for unsafe sex, intimate partner violence, and drug use showed a significant increase from 1990 to 2021 in China and the Western Pacific Region (all AAPC > 0, p < 0.05). Notably, the HIV burden was consistently higher in males than females in both regions, with most of gender disparities widening over time. CONCLUSION: Despite significant progress in HIV/AIDS response, the burden remains substantial, with notable gender differences. Strengthened international cooperation, targeted prevention strategies, and expanded access to treatment are crucial to mitigating new HIV infections and improving health outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".