Regional deprivation and HIV/AIDS outcomes in China: an ecological study using provincial surveillance data

Abstract Motivations Regional development in China is uneven, and the annual number of newly reported HIV cases varies across regions. However, empirical studies on the impact of regional development imbalances on HIV/AIDS in China are limited. Methods Comparisons were made between regions of different levels of deprivation, examining trends in HIV incidence and AIDS mortality, as well as ratios of HIV incidence and AIDS mortality. Regional deprivation was measured using the General Deprivation Index (GDI). Joinpoint regression was applied to analyze temporal trends, and negative binomial regression was used to estimate incidence and mortality ratios, with the least deprived regions (Q1) as the reference. Results Eastern coastal regions had lower GDI values, whereas western regions had higher GDI values, indicating higher deprivation. From 2010 to 2019, the annual percentage change (APC) in HIV incidence in the highest deprivation regions was 10.94% (95% CI: 9.67%–12.22%), and the APC in AIDS mortality was 14.19% (95% CI: 12.32%–16.10%). HIV reported incidence and AIDS mortality ratios in the highest deprivation regions compared to the lowest were 1.30 (95% CI: 1.11–1.52) and 2.19 (95% CI: 1.78–2.70), respectively. Conclusion A non-linear association was observed between deprivation and HIV incidence, with Q4 regions bearing the heaviest disease burden, emphasizing the need to prioritize HIV/AIDS prevention and control in these areas.