Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Mar 31, 2026
Date Accepted: Aug 26, 2026
Prevalence, trends, and correlations of HIV, syphilis, and anti-HCV infections among attendees at HIV Voluntary Counseling and Testing clinics in Zhejiang Province, China from 2022 to 2024
ABSTRACT
Background:
Following the COVID-19 pandemic, the trends of human immunodeficiency virus (HIV), syphilis and hepatitis C (HCV) infections as well as the prevalence of coinfections among high risky group may have changed, yet there have been relatively few relevant studies.
Objective:
To assess the seroprevalence rates and coinfection rates of HIV, syphilis, and HCV among people engaging in high-risk behaviors, a relevant analysis was conducted among individuals attending CDC-based VCT clinics from 2022–2024.
Methods:
Data were extracted in January 2025 from the National HIV/AIDS Information Prevention and Control System. Information in the database with respect to the individuals who received HIV counseling and testing at VCT clinics of CDC between 2022 and 2024 were included in the study. Univariate and multivariate Binary logistic regression was used to describe trends in positive rates related to HIV, syphilis, and anti-HCV from 2022–2024, and to identify relevant indicators of HIV-positive rate, syphilis-positive rate, and anti-HCV-positive rate.
Results:
The HIV positivity rate decreased from 2.462% (743/30,182) in 2022 to 1.664% (681/40,916) in 2024 (χtrend2 = 53.569; P<.001). The syphilis positivity rates were 1.378% (414/30,049), 1.502% (161/44,951), and 1.620% (647/39,929) in 2022, 2023, and 2024, respectively (χtrend2 = 6.822; P = .009). The proportions of anti-HCV-positive rate were 0.309% (77/24,950), 0.387% (161/41,593), and 0.504% (192/39,098) in 2022, 2023, and 2024, respectively (χtrend2 = 14.795; P<.001). In 2024, the proportions of positive rates of HIV & anti-HCV, HIV & syphilis, and HIV & syphilis & HCV were 0.010%, 0.233%, and 0.005%, respectively. Multivariate logistic regression analysis showed that ≧35 years old and HIV testing history were independent risky factors for HIV, syphilis and anti-HCV positivity; having a senior high school education and above were independent protective factor for HIV, syphilis and anti-HCV positivity; Compared with consulting for casual heterosexual behavior, consulting for homosexual behavior was associated with a higher risk of HIV positive rate (aOR = 1.752, 95% CI: 1.390–2.208) and lower risk of anti-HCV positivity (aOR = 0.059, 95% CI: 0.022-0.158).
Conclusions:
From 2022 to 2024, the HIV and anti-HCV positive rates among VCT clients at the CDC had been declining, while the syphilis positive rate had been increasing. The co-positive rates of those three diseases were very low. Priority should be given to populations with advanced age, low educational attainment, and a HIV testing history. Interventions and testing should be strengthened for clients who receive outreach services or were referred to the CDC. Homosexual behavior constituted a high-risk group for HIV positivity, yet were associated with a lower prevalence of anti-HCV positivity. Clinical Trial: 2026-038-01
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