National preoperative HIV prevalence in China: a retrospective analysis of 4,753,874 surgical patients.

The China National HIV Study (CNHS) on the surgical patient population aimed to investigate the preoperative HIV positive rate and secular trends in the surgical patient population of China. The CNHS included a nationally representative sample of participants who were diagnosed with HIV infection between 2009 and 2018 during preoperative screening selected from 27 comprehensive hospitals in nine provinces using a stratified random sampling methodology. The preoperative HIV positive rate was estimated according to age, sex, occupation, urbanization, and hospital level. An ARIMA model was developed to predict HIV trend from 2019 to 2023. A total of 4,753,874 patients, including 2,830,307 males with an average age of 45·3 years, participated in the CNHS. HIV infection was diagnosed in 2,858 individuals (6·0 per 10,000), and increased from 19·5 (14·4-24·6) per 100,000 in 2009 to 84.8(77.2-92.3) in 2016, decreased from 75.2 (68.3-82.0) in 2017 to 74·3 (67·7-81·0) in 2018. Compared to 2009, the annual growth rate of preoperative HIV positive rate in 2018 was 381%, with most patients being male (567%), aged ≥ 50 years (423%), official staff (1508%), and unemployed (1153%). The predicted HIV positive rate from 2019 to 2023 showed an overall decreasing trend in ARIMA(2,1,3)(1,1,2)4 model. The first time preoperative HIV positive rate in the surgical patient population with a ten-year secular trend was report. Increasing trend was seen from 2009 to 2016 with a slight decreasing from 2017, which implied a positive comment on the current HIV prevention programs.