[Analysis of the referral time difference and related factors from newly confirmed HIV-infected cases to antiretroviral treatment in 10 cities of Shandong Province].

Objective

To analyze the referral time interval and related factors of antiretroviral treatment for newly confirmed HIV-infected cases and to provide a reference basis for optimizing the connection mechanism of AIDS referral treatment in Shandong Province.

Methods

A cross-sectional study design was adopted. From September 2024 to March 2025, 10 cities in Shandong Province with a relatively high rate of new HIV infection were selected. The subjects were recruited through local designated hospitals, and face-to-face questionnaire surveys were conducted to collect information on the sociodemographic characteristics of the research subjects, knowledge of AIDS diagnosis and treatment, perceived discrimination against HIV, HIV testing and intervention situations, and ART. The generalized linear mixed-effects model (GLMM) was used to analyze the related factors of the referral time interval for antiviral treatment in newly confirmed HIV-infected individuals. Statistical analysis was performed using R 4.3.3 software.

Results

Among the 447 newly confirmed HIV-infected cases, the average age was (36.92±12.31) years. The majority were male (93.27%, 416/446), had a high school education or below (51.90%, 232/447), were unmarried (49.22%, 220/447), and had a homosexual sexual orientation (40.99%, 182/444). The median (Q1, Q3) interval for referring new HIV-infected individuals for antiviral treatment was 6 (4, 13) days. There was a statistically significant difference in the referral interval among different cities (P<0.001). The results of the generalized linear mixed-effects model analysis showed that the related factors of the referral interval included age, gender, sexual orientation, diagnosis knowledge score, number of active tests, baseline CD4+T lymphocyte count, and distance to the designated hospital.

Conclusions

Overall, the referral time intervals for antiretroviral treatment of newly confirmed HIV-infected cases were relatively short in 10 cities of Shandong Province. There were differences in the referral time intervals among different cities. There were many factors influencing the referral time intervals. It is necessary to strengthen health education, promote active testing for HIV, optimize medical resource allocation, and formulate differentiated intervention strategies for different infected groups.