Longitudinal trends in HIV/AIDS adults aged over 60 years: A multidimensional decomposition with global and regional comparisons, 1990–2021

IF 4 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-09-01 DOI:10.1016/j.jiph.2025.102944

Yanhui Ma , Weifang Tong , Yi Liu , Ning Yin , Lisong Shen , Chaoyan Yue

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引用次数: 0

Abstract

Background

Antiretroviral therapy has extended the lifespan of HIV/ADIS. However, research and policies mainly target younger groups, leaving gaps in the care for aging people living with HIV (PLHIV).

Methods

Using data from the 2021 Global Burden of Disease Study, this research evaluated the global, regional, and national burdens of HIV/AIDS in adults aged 60 and above from 1990 to 2021. Key metrics were analyzed, and trends were predicted through various regression methods. Decomposition analysis identified the drivers of burden changes.

Results

Bayesian Age-Period-Cohort (BAPC) model predicted the global HIV/AIDS incidence, prevalence and mortality rate will rise across older aged groups, with an increasing absolute number of cases from 2022 to 2035. Among those over 60, absolute cases grew despite a −2.48 % EAPC. Age-standardized prevalence rate (ASPR) and age-standardized mortality rate (ASMR) rose by 580.76 % and 102.44 % respectively, with EAPCs of 5.32 and 0.22. Those aged 60–69 made up over 50 % of cases, with males being dominant. Temporal trends indicated a general decline in age-standardized incidence rate (ASIR) and ASMR but a sharp rise in ASPR between 1990 and 2021. The total APC was −0.16 for ASIR, 0.102 for ASMR, and 9.62 for ASPR. Although ASIR remained low in high SDI regions, it showed a modest increase with EAPC of 2.33, indicating a slow but steady rise in new infections. Mortality and Disability-adjusted life years (DALYs) cases in high-middle and middle SDI regions increased by 2–8 folds, with EAPCs from 3.33 to 5.32, indicating a growing disease burden. Population growth was the dominant driver of rising incidence and mortality.

Conclusions

The growing HIV/AIDS burden among older adults underscores the dual challenges of aging and demographic shifts over the past 30 years. The increasing prevalence, mortality, and DALYs in aging populations underscore the urgent need for age-responsive HIV/AIDS strategies.

查看原文本刊更多论文

60岁以上成年人艾滋病毒/艾滋病的纵向趋势：1990-2021年全球和区域比较的多维分解

抗逆转录病毒治疗延长了艾滋病毒/艾滋病患者的寿命。然而，研究和政策主要针对较年轻的群体，在对老年艾滋病毒感染者的护理方面留下了空白。方法利用2021年全球疾病负担研究的数据，本研究评估了1990年至2021年60岁及以上成年人的全球、地区和国家艾滋病毒/艾滋病负担。分析了关键指标，并通过各种回归方法预测了趋势。分解分析确定了负担变化的驱动因素。结果贝叶斯年龄-时期-队列（BAPC）模型预测，从2022年到2035年，全球艾滋病毒/艾滋病的发病率、患病率和死亡率将在老年群体中上升，绝对病例数将增加。在60岁以上的患者中，尽管EAPC为- 2.48 %，但绝对病例数仍在增加。年龄标准化患病率（ASPR）和年龄标准化死亡率（ASMR）分别上升了580.76 %和102.44 %，eapc分别为5.32和0.22。60-69岁的人占病例的50% %以上，以男性为主。时间趋势表明，1990年至2021年间，年龄标准化发病率（ASIR）和ASMR总体下降，但ASPR急剧上升。ASIR的总APC为- 0.16，ASMR为0.102，ASPR为9.62。虽然ASIR在高SDI地区仍然很低，但它显示出温和的增加，EAPC为2.33，表明新感染缓慢但稳定地上升。SDI中高和中高地区的死亡率和残疾调整生命年（DALYs）病例增加了2-8 倍，eapc从3.33增加到5.32，表明疾病负担不断增加。人口增长是发病率和死亡率上升的主要原因。结论：在过去的30年里，老年人艾滋病负担的增加凸显了老龄化和人口结构变化的双重挑战。老年人口的流行率、死亡率和伤残调整生命年不断增加，强调了迫切需要针对年龄的艾滋病毒/艾滋病战略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.