Older adults at high risk of HIV infection in China: a systematic review and meta-analysis of observational studies

Yuan Yuan Wang; Yuan Yang; Chang Chen; Ling Zhang; Chee H Ng; Gabor S Ungvari; Xiaohua Douglas Zhang; Yu-Tao Xiang

doi:10.7717/peerj.9731

Older adults at high risk of HIV infection in China: a systematic review and meta-analysis of observational studies

PeerJ. 2020 Oct 21:8:e9731. doi: 10.7717/peerj.9731. eCollection 2020.

Authors

Yuan Yuan Wang^#¹, Yuan Yang^#^{2

3}, Chang Chen², Ling Zhang⁴, Chee H Ng⁵, Gabor S Ungvari^{6

7}, Xiaohua Douglas Zhang², Yu-Tao Xiang²

Affiliations

¹ Faculty of Health and Life Sciences, De Montfort University, Leicester, United Kingdom.
² Center for Cognition and Brain Sciences, University of Macau, University of Macau, Macao SAR, China.
³ Department of Psychiatry and Psychology, Southern Medical University Nanfang Hospital, Guangdong, China.
⁴ The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & the Advanced Innovation Center for Human Brain Protection, Beijing Anding Hospital, School of Mental Health, Capital Medical University, Beijing, China.
⁵ Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia.
⁶ University of Notre Dame Australia, Perth, Fremantle, Australia.
⁷ Division of Psychiatry, Medical School, University of Western Australia, Perth, Australia.

^# Contributed equally.

Abstract

There is an increasing prevalence of human immunodeficiency virus (HIV) infection in older adults in China, but the findings across prevalence studies have been mixed. This is the first meta-analysis of the prevalence of HIV infection and its moderating factors in older adults in China. Two investigators systematically and independently searched both international (PubMed, PsycINFO, Web of Sciences and EMBASE) and Chinese (WanFang, CNKI, and CQVIP) databases. HIV infection rates in older adults were analyzed using the random-effects model. Altogether 46 studies were included in the analysis. The pooled prevalence of HIV infection in older adults was 2.1% (95% CI [1.9%-2.3%], I ² = 99.4%). Subgroup analyses revealed that men who have sex with men (MSM), hospital population samples, publications after 2014, studies conducted in the western region of China, and higher study quality were significantly associated with higher HIV infection rate. This meta-analysis found that the HIV infection prevalence in older adults is significantly higher than the general population in China. Attention should be given to this urgent public health issue, and effective HIV/AIDS preventive, screening and treatment measures are warranted in this population. PROSPERO: CRD42019124286.

Keywords: China; HIV/AIDS; Meta-analysis; Older adults.

Grants and funding

The study was supported by the University of Macau (MYRG2015-00230-FHS; MYRG2016-00005-FHS), the National Key Research & Development Program of China (No. 2016YFC1307200), the Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (No. ZYLX201607) and the Beijing Municipal Administration of Hospitals’ Ascent Plan (No. DFL20151801). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.