Study on the characteristics and influencing factors on non-marital non-commercial heterosexual transmission of HIV/AIDS in Anhui Province, China, 2015-2022.

Background: To understand the newly reported prevalence rate and its influencing factors of non-marital non-commercial heterosexual contact (NMNCHC) of persons with HIV from 2015 to 2022, in Anhui Province, China. In order to provide a reference basis of HIV prevention and control for targeted people.

Methods: The information of newly reported persons with HIV in Anhui Province from the year 2015 to 2022 was downloaded from the Chinese HIV/AIDS Comprehensive Response Information Management System (CRIMS). Multivariate binary unconditional logistic regression models were conducted to explore the factors influencing HIV infection by NMNCHC.

Results: The newly reported persons with HIV in Anhui Province from 2015 to 2022 totaled 22,841 cases, and the number of persons with HIV who had a history of non-marital heterosexual contact (NMHC) was 10,989 cases. Of these, 4,817 (43.8%) cases had NMNCHC, the share of which increased from 40.75% in 2015 to 48.59% in 2022. Non-marital commercial heterosexual contact (NMCHC) was more common in males (67.1%) while NMNCHC was more common in females (85.6%). Multivariate binary unconditional logistic regression analysis showed that other ethnicity(OR = 0.599, 95% CI: 0.383-0.937), number of sexual partners > 3(OR = 0.153, 95% CI: 0.112-0.209), never had sexually transmitted infections (STIs) (OR = 2.482, 95% CI: 1.606-3.834) were the factors influencing NMNCHC among females; while higher age[30-40 years (OR = 0.675, 95% CI: 0.569-0.801 ), 40-50 years (OR = 0.534, 95% CI: 0.446-0.639), 50-60 years (OR = 0.501, 95% CI: 0.414-0.606), and ≥ 60 years (OR = 0.402, 95% CI: 0.330-0.490)], local residents (OR = 0.649, 95% CI: 0.583-0.723), number of sexual partners > 3 (OR = 0.302, 95% CI: 0.264-0.347), higher education level [middle school: (OR = 1.159, 95% CI: 1.024-1.313); high school or technical secondary school: (OR = 1.371, 95%CI: 1.159-1.623); college degree or above: (OR = 1.719, 95% CI: 1.412-2.093)], never had STIs (OR = 1.327, 95% CI: 1.111-1.586) were the factors influencing NMNCHC among males.

Conclusions: The proportion of newly reported persons with HIV in Anhui Province with a history of NMHC was high, and the proportion of NMNCHC showed an increasing trend year by year. For the female population, special attention should be given to high-risk individuals who have not previously contracted STIs, providing them with relevant sexual education and HIV awareness training. For the male population, focus should be placed on individuals, specifically those with higher education and those who have not previously contracted STIs. Additionally, local HIV prevention and control campaigns and services should be strengthened to enhance residents' awareness of prevention and their self-protection capabilities, thereby reducing the risk of HIV transmission through sexual behavior.