Trends in Bidirectional Screening and Treatment Outcomes for Tuberculosis/HIV Comorbidity — China, 2020−2024

Guoqin Zhang^1,&, Qinglin Meng^2,&, Ting Qu¹, Lin Zhou², Eryong Liu^2,#

1. Tianjin Center for Tuberculosis Control, Tianjin, China;

2. National Center for Tuberculosis Control and Prevention, Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing, China.

^& Joint first authors.

^# Corresponding author: Eryong Liu, liuey@chinacdc.cn.

The comorbidity of tuberculosis (TB) and HIV/AIDS represents a persistent global public health challenge. This study examines the epidemiological trends of TB/HIV comorbidity in China during 2020–2024, extending previous analyses from the 2015–2019 period. We collected annual TB/HIV comorbidity surveillance data from 32 provincial-level administrative divisions (PLADs) in China, encompassing bidirectional screening protocols, treatment initiation rates, and clinical outcomes. TB screening among people living with HIV (PLHIV) incorporated systematic symptom assessment and chest X-ray or sputum examination. HIV testing for TB patients employed standard serological methodologies. We performed statistical analyses and generated spatial distribution maps using R 4.2.1. During 2020–2024, 5,970,062 PLHIV were registered nationwide, with TB examination coverage increasing significantly from 90.2% (957,844/1,061,665) to 94.3% (1,246,274/1,321,458) (P < 0.01). The overall TB detection rate among PLHIV was 0.5% (27,991/5,506,876). Among 2,843,159 registered TB patients, HIV testing coverage rose from 67.1% (419,332/625,395) to 68.7% (375,488/546,386) (P < 0.01), yielding an overall HIV positivity rate of 1.1% (22,030/1,937,418). We identified 31,783 TB/HIV comorbid patients, of whom 70.9% (21,139/29,836) received concurrent antiretroviral therapy (ART) and anti-TB treatment. Treatment success rates declined significantly from 88.6% (9,521/10,751) in 2020 to 82.9% (3,743/4,513) in 2024 (P < 0.01), while mortality increased from 4.8% (515/10,751) to 8.8% (398/4,513) (P < 0.01). Although bidirectional screening coverage has improved, substantial regional disparities persist alongside concerning trends of declining treatment success rates and increasing mortality. Enhanced implementation of efficient diagnostic technologies, optimized treatment protocols, and comprehensive stigma reduction initiatives are essential to improve survival outcomes for TB/HIV comorbid patients.

结核病/艾滋病共病患者双向筛查和治疗趋势 — 中国，2020−2024年

张国钦^1,&, 孟庆琳 ^2,&, 曲婷 ¹, 周林 ², 刘二勇 ^2,#

1. 天津市结核病控制中心，天津，中国；

2. 结核病预防控制中心，中国疾病预防控制中心（中国预防医学科学院），北京，中国。

^& 共同第一作者。

^# 通信作者: 刘二勇，liuey@chinacdc.cn。

结核病（TB）与艾滋病（HIV/AIDS）的共病是一项持续存在的全球公共卫生挑战。本研究分析了中国2020至2024年期间TB/HIV共病的流行病学趋势，延续了先前对2015-2019年期间的分析。本研究收集了中国32个省级行政区（PLADs）的年度TB/HIV共病监测数据，涵盖双向筛查、治疗开展情况和治疗结局。对艾滋病病毒感染者（PLHIV）的结核病筛查包括系统性的症状评估以及胸部X光或痰液检查。对结核病患者的HIV检测采用标准血清学方法。使用R 4.2.1软件进行了统计分析并生成了空间分布图。2020-2024年期间，全国共登记了5,970,062名HIV感染者，接受结核病检查的覆盖率从90.2% (957,844/1,061,665) 显著提升至94.3% (1,246,274/1,321,458) (P < 0.01)。HIV感染者中结核病的总体检出率为0.5% (27,991/5,506,876)。在2,843,159名登记的结核病患者中，HIV检测覆盖率从67.1% (419,332/625,395) 上升至68.7% (375,488/546,386) (P < 0.01)，总体HIV阳性率为1.1% (22,030/1,937,418)。共确诊了31,783名TB/HIV共病患者，其中70.9% (21,139/29,836) 接受了抗逆转录病毒治疗（ART）和抗结核治疗的同步治疗。结核病治疗成功率从2020年的88.6% (9,521/10,751) 显著下降至2024年的82.9% (3,743/4,513) (P < 0.01)，而病死率则从4.8% (515/10,751) 上升至8.8% (398/4,513) (P < 0.01)。尽管双向筛查覆盖率有所提高，但显著的地区差异依然存在，同时伴随着治疗成功率下降和病死率上升的趋势。加强高效诊断技术的应用、优化治疗方案以及实施综合性措施减少污名化，对于改善TB/HIV共病患者的生存结局至关重要。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.253

A Volunteer-Based Social Network Strategy to Promote HIV Testing Among MSM Aged 50 and Above — Tianjin Municipality, China, 2021–2024

Hui Gong¹, Xin Wang¹, Zhongquan Liu¹, Fangning Zhao¹, Jinyu Hou¹, Jie Yang², Fengli Liu², Maohe Yu^1,#, Chu Zhou^3,#

1. Tianjin Centers for Disease Control and Prevention, Tianjin, China;

2. Shenlan Public Health Consulting Service Center, Tianjin, China;

3. National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing, China.

^# Corresponding author: Chu Zhou, zhouchu@chinaaids.cn; Maohe Yu, fish820225@sina.com.

HIV prevalence among men who have sex with men (MSM) aged 50 and above has been increasing. This population has a low testing rate and insufficient knowledge of human immunodeficiency virus/ acquired  immune  deficiency  syndrome (HIV/AIDS) prevention. At present, limited strategies are available for improving the testing coverage of elderly MSM. A 2021–2024 study in Tianjin evaluated Volunteer-Based Social Network HIV Testing Services (VBSNS) for MSM aged 50 and above. Compared to traditional Community-Based HIV Testing Services (CBHTS), VBSNS showed effectiveness: Among the HIV testing conducted by Community-Based Organization  (CBO) in Tianjin targeting men who have sex with men (MSM) aged 50 and above, it accounted for 47.9% of total HIV testing, 66.6% of suburban HIV testing, and identified 67.2% of newly reported HIV-positive cases. It also effectively engaged high-risk groups, including those with lower education and limited prior testing experience.This model proves feasible for remote regions where traditional services are inaccessible, offering a scalable solution to improve HIV testing coverage and case detection among elderly MSM.

基于志愿者社会网络促进50岁及以上男男性行为者HIV检测 — 天津市，中国，2021–2024年

龚卉¹, 王鑫¹, 柳忠泉¹, 赵芳凝¹, 候金余¹, 杨杰², 刘凤利², 于茂河^1,#, 周楚^3,#

1. 天津市疾病预防控制中心，天津，中国；

2. 深蓝公共卫生咨询服务中心，天津，中国；

3. 性病艾滋病预防控制中心，中国疾病预防控制中心（中国预防医学科学院），北京，中国。

^# 通信作者：周楚，zhouchu@chinaaids.cn; 于茂河，fish820225@sina.com。

50岁及以上男男性行为者（MSM）的艾滋病病毒（HIV）感染率持续上升。该人群HIV检测率较低，且对HIV的预防知识掌握不足。目前，针对提高老年MSM人群HIV检测覆盖率的有效策略较为有限。2021-2024年，在天津开展的一项研究对面向50岁及以上MSM人群的“基于志愿者社交网络的HIV检测服务（VBSNS）”进行了效果评估。与传统的“基于社区的HIV检测服务（CBHTS）”相比，VBSNS成效明显：在天津社会组织开展的50岁及以上MSM人群的HIV检测中，VBSNS贡献了47.9%的总检测量、66.6%的郊区检测量，并发现了67.2%的新报告HIV阳性病例。此外，该服务还成功覆盖了低学历、既往检测经历较少等高危群体。这一模式在传统检测服务难以覆盖的偏远地区具有良好可行性，为提高老年MSM人群HIV检测覆盖率与病例发现率提供了可推广的解决方案。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.254

HIV Prevention Cascade and PrEP/PEP Implementation Gaps Among High-Risk University Students — Sichuan Province, China, 2022–2023

Chunhua Tian^1,&, Rui Shen^2,&, Qian Hu³, Yiming Wang⁴, Meixia Qu⁵, Junjie Wang^3,#

1. Sichuan Center for Disease Control and Prevention, Chengdu City, Sichuan Province, China;

2. School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China;

3. Chinese Center for Disease Control and Prevention (Chinese Academy of Preventive Medicine), Beijing, China;

4. School of Public Health Jilin University, Changchun City, Jilin Province, China

5. Chinese Association of STD & AIDS Prevention And Control, Beijing, China.

^& Joint first authors.

^# Corresponding authors: Junjie Wang, wangjunjie@chinaaids.cn.

Chinese university students face elevated HIV risks, yet PrEP and PEP uptake remains low despite proven efficacy. Among 645 high-risk students, 12.87% used PrEP and 13.02% used PEP. High HIV knowledge strongly predicted awareness (PrEP: aOR=5.62; PEP: aOR=3.42), but 70% of students who understood services did not access them, indicating structural barriers outweigh knowledge deficits as the primary constraint limiting cascade effectiveness. Educational interventions alone are insufficient; comprehensive strategies simultaneously addressing knowledge deficits and systemic barriers are essential to access PrEP and PEP.

高危行为大学生HIV预防级联及暴露前/暴露后预防用药实施障碍研究 — 四川省，中国，2022–2023年

田春华^1,&，沈蕊^2,&，胡茜³，王一鸣⁴，曲美霞⁵，王俊杰^3,#

1.四川省疾病预防控制中心，成都市，四川省，中国；

2.中国医学科学院北京协和医学院群医学公共卫生学院，北京，中国；

3.中国疾病预防控制中心（中国预防医学科学院），北京，中国；

4.吉林大学公共卫生学院，长春市，吉林省，中国；

5.中国性病艾滋病防治协会，北京，中国。

^& 共同第一作者

^# 通信作者：王俊杰, wangjunjie@chinaaids.cn。

中国大学生面临较高的HIV感染风险，暴露前预防（PrEP）和暴露后预防（PEP）已被证实有效，但目前使用率仍然较低。本研究纳入四川省645名高危大学生，发现PrEP使用率为12.87%，PEP使用率为13.02%。高水平HIV相关知识与预防服务知晓率显著相关（PrEP：aOR=5.62；PEP：aOR=3.42），但在已知晓服务使用方法的学生中，仍有70%未实际获取服务。研究表明，结构性障碍而非知识缺乏是限制预防级联有效性的主要制约因素。单纯的健康教育干预不足以提高PrEP/PEP的可及性，亟需制定同时解决知识缺陷和系统性障碍的综合性策略。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.256