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| Factors affecting loss to follow-up among HIV/AIDS cases in Gulou District from 1994 to 2025 |
| XU Fen, ZHANG Li, WANG Ling, WANG Jing, ZHANG Hang
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| Gulou District Center for Disease Control and Prevention, Nanjing, Jiangsu 210003, China |
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Abstract Objective To understand the status and influencing factors of loss to follow-up among HIV/AIDS cases in Gulou District, Nanjing City, so as to provide evidence for optimizing the follow-up management of HIV/AIDS cases. Methods Reporting information and follow-up data of HIV/AIDS cases in Gulou District from January 1, 1994, to July 31, 2025, were collected through the HIV/AIDS Comprehensive Control System of Chinese Disease Prevention and Control Information System. The confirmed date of HIV/AIDS diagnosis was defined as the start of follow-up observation, and July 31, 2025, as the end of observation , with loss to follow-up as the outcome event. Factors affecting loss to follow-up among HIV/AIDS cases were analyzed using a multivariable Cox proportional risk regression model. Results A total of 1 279 HIV/AIDS cases were observed from January 1, 1994, to July 31, 2025, with a total observation period of 8 834.23 person-years. There were 1 198 males (93.67%) and 81 females (6.33%). The median age was 32.00 (interquartile range, 20.00) years. There were 848 HIV-infected individuals (66.30%) and 431 AIDS patients (33.70%). As of July 31, 2025, 152 cases were lost to follow-up, with a loss to follow-up density of 17.21 thousand person-years and a cumulative loss to follow-up rate of 11.88%. Multivariable Cox proportional risk regression analysis showed that HIV/AIDS cases with non-Jiangsu household registration (HR=1.721, 95%CI: 1.212-2.444), passive testing (HR=2.031, 95%CI: 1.346-3.065), and heterosexual transmission (HR=2.542, 95%CI: 1.669-3.872) had a higher risk of loss to follow-up, whereas those who were married/with a spouse (HR=0.432, 95%CI: 0.283-0.661), AIDS patients (HR=0.152, 95%CI: 0.085-0.271), reported by general hospitals (HR=0.382, 95%CI: 0.226-0.645) or Centers for Disease Control and Prevention (HR=0.505, 95%CI: 0.323-0.790) had a lower risk of loss to follow-up. Conclusions The risk of loss to follow-up among HIV/AIDS cases was mainly associated with residence, marital status, HIV/AIDS stage, reporting institution, case detection method, and route of infection. Cases at high risk of loss to follow-up should be prioritized, and follow-up mana gement should be strengthened to reduce the occurrence of loss to follow-up.
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Received: 19 November 2025
Revised: 29 January 2026
Published: 27 May 2026
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