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ORIGINAL RESEARCH article

Front. Public Health

Sec. Infectious Diseases: Epidemiology and Prevention

Temporal Dynamics and Demographic Specificity of Provider-Initiated HIV Testing in China: An eight-year Retrospective Analysis

Provisionally accepted
Yuexin  SunYuexin SunQiaofang  WuQiaofang WuYue  TaoYue Tao*Haoyue  YuHaoyue YuYing  ZhouYing ZhouJun  BaoJun Bao*
  • Nanjing Drum Tower Hospital, Nanjing, China

The final, formatted version of the article will be published soon.

Background: This study evaluates the effectiveness of PITC implementation at Nanjing Drum Tower Hospital from 2017 to 2024 and examines variations in testing efficiency across different populations and time periods, aiming to provide critical evidence for adjusting PITC strategies to adapt to epidemiological changes. Methods: A cross-sectional analysis study was conducted on 907,395 patients who underwent HIV testing at Nanjing Drum Tower Hospital from 2017 to 2024. Patients were divided into routine testing group (RT group) (n=879,503) and PITC group (n=27,892). Chi-square tests and Cochran-Armitage trend tests were employed to compare HIV positivity rates and temporal trends between the two groups. Results: The overall HIV positivity rate in the PITC group (0.51%) was significantly higher than in the RT group (0.10%) (χ² = 718.5, p < 0.001), although the effect size was modest (V = 0.028). Time trend analysis revealed a significant decline in the positivity rate within the PITC group, from 0.83% in 2017 to 0.30% in 2024 (Z = -2.96, p = 0.003). In contrast, the positivity rate in the RT group remained relatively stable (0.07% - 0.13%). The PITC group was predominantly male (67.5%), largely composed of young adults aged 20-40 years (61.8%), with unmarried individuals accounting for 63%. Conversely, the RT group consisted mainly of middle-aged and elderly married women (58.2%) ,with a higher proportion undergoing first-time testing (72.5%). Notably, the HIV positive rate in the PITC group dropped significantly in 2023 and 2024, reaching 0.20% and 0.30% respectively, potentially due to the "dilution effect" following an expansion of the testing population or issues related to data quality. Conclusion: PITC demonstrated significant improvements in HIV testing efficiency during 2017-2022.

Keywords: HIV testing, Provider-Initiated Testing and Counseling (PITC), Positivity Rates, retrospective analysis, Epidemiological trends

Received: 23 Apr 2025; Accepted: 07 Nov 2025.

Copyright: © 2025 Sun, Wu, Tao, Yu, Zhou and Bao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Yue Tao, peachyue@126.com
Jun Bao, baojun196805@163.com

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