HIV/AIDS burden, attributable risk factors, and projections among reproductive-age adults in China, 1990–2035: A GBD 2023 analysis

by Huibo Yan Background HIV/AIDS remains a leading infectious disease burden globally. While highly active antiretroviral therapy has transformed HIV into a manageable chronic condition, contemporary trends and attributable risk factors among reproductive-age adults in China—a critical demographic for epidemic control—remain poorly characterized.

This study provides an updated comprehensive assessment of HIV/AIDS burden in this population using Global Burden of Disease Study 2023 data, which incorporates methodological refinements and post-pandemic data not available in earlier versions. Methods We extracted age-standardised incidence, prevalence, mortality and disability-adjusted life-years (DALYs) for Chinese adults aged 15–49 years from GBD 2023.

Joinpoint regression estimated annual percent change and identified significant trend inflection points. Population attributable fractions were analysed for unsafe sex, drug use, and intimate-partner violence.

ARIMA models forecasted burden trends to 2035 with 95% uncertainty intervals. Results Between 1990 and 2023, age-standardised rates increased substantially: incidence +301% (from 0.82 to 3.29 per 100,000), prevalence +774% (4.84 to 42.29), mortality +1,623% (0.13 to 2.24), and DALYs + 1,439% (7.96 to 122.48).