Trends, Age-Period-Cohort Effects, and Projections in the Incidence and Mortality of HIV/AIDS among the Elderly in China

Abstract Background HIV/AIDS among the elderly presents a new public health challenge in China. We aimed to explore historical trends (2004–2018) and project the future (2019–2030) burden of HIV/AIDS incidence and mortality among the elderly in China. Methods We utilized data from the Data Center of China Public Health Science database on HIV/AIDS incidence and mortality, employing the Bayesian age-period-cohort model to reveal the age-period-cohort effect in the HIV/AIDS burden, and projecting the incidence and mortality rates up to 2030. Results From 2004 to 2018, HIV/AIDS incidence rates increased from 0.56/105 to 20.78/105 for men and 0.28/105 to 7.84/105 for women. The mortality rates also elevated in both genders. We observed the highest age effect in incidence among the men aged 70-74 and women aged 55-59, with the effect estimates being 0.02 (95% CI: -0.10 to 0.13) and 0.46 (95% CI: 0.35 to 0.57). Similar gender disparities were observed for the mortality, with the highest age effect observed in men aged 75-79 and women aged 50-54. However, no significant disparities were found between men and women in the period and cohort effects. By 2030, the incidence rates were projected to be 96.25/105 in men and 44.90/105 in women, while the mortality rates were projected to be 48.27/105 and 13.67/105. Conclusion HIV/AIDS incidence and mortality rates rose notably among the elderly in China and are expected to keep increasing in the coming decades. Rates were consistently higher in men than in women. Tailored interventions for older men are crucial.