Abstract：Objective To analyze the timeliness of antiretroviral therapy initiation among newly reported HIV/AIDS adult cases in Hunan Province from 2016 to 2020, to investigate the status of implementation of Treat All Policies in Hunan Province, and to explore the relevant factors affecting the work. Methods We analyzed the follow-up management data and antiviral treatment management data of Hunan Province from 2016 to January 2021 from the Basic Information System for HIV/AIDS Prevention and Control of Chinese Center for Disease Control and Prevention. The timely initiation of antiretroviral therapy in different years and the possible influencing factors were surveyed. Results Among 31,635 newly reported HIV/AIDS adult cases, the sex ratio was 3.54:1, and the median age 48 (33, 60) years old. The unmarried/divorced, farmers and heterosexual transmission accounted for 54.17%, 55.11% and 77.31%, respectively. The overall rate of timely initiation of antiretroviral therapy in 2016-2020 was 61.85%, and the median enrollment time 20 days. The timely treatment rate increased from 51.65% in 2016 to 67.91% in 2020 (χ2trend=550.060, P<0.001). Female (OR=1.228, 95%CI:1.150-1.311) and detection and consultation cases (OR=1.169, 95%CI:1.104-1.237) were easier to initiate antiretroviral therapy in time. The unmarried (OR=0.792, 95%CI:0.749-0.837), workers (OR=0.765, 95%CI:0.680-0.860), commercial service persons (OR=0.828, 95%CI:0.749-0.916),residents with a household registration in other provinces (OR=0.604, 95%CI:0.528-0.691), injecting drug users (OR=0.487, 95%CI:0.357-0.664), cases from detection in detainees (OR=0.165, 95%CI:0.127-0.214) or other sources (OR=0.732, 95%CI:0.647-0.829), cases withuntimely detection of CD4+T lymphocytes (OR=0.201, 95%CI:0.190-0.212) and cases with a higher level of first CD4 cell count (OR≥500=0.613, 95%CI:0.566-0.663) were difficult to initiate antiretroviral therapy in time. Conclusion Hunan Province has progressed in implementing Treat All Policies, but the timely initiation of antiretroviral therapy still needs to be improved. It is necessary to strengthen the management, mobilization and referral of targeted treatment for males, the unmarried, floating people, drug addicts and detainees. Publicity and consultation should be done before and after the testing, and follow-up survey should be carried out in time to avoid loss of follow-up. Follow-up and treatment referral mode should be optimized to improve the timely initiation of antiretroviral therapy.
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2022, Vol. 29 
