Different transmission routes and the risk of advanced HIV disease: A systematic review and network meta-analysis of observational studies

摘要: Abstract Background A substantial proportion of people living with HIV (PLHIV) present for care advanced disease (AHD), which may result in difficulty reaching the “90–90–90” target to end AIDS 2030. We assessed risk AHD different transmission routes summarize evidence priority prevention strategies key populations. Methods Observational studies published before September 10th, 2019 PubMed, EMBASE, Web Science and Chinese electronic databases were analysed. The outcomes interest number PLHIV patients their associated routes. among using multi-armed network meta-analysis based on Bayesian method. associations between regional policies sex work compulsory drug treatment estimated ecological linear regression. Findings One hundred one articles included, covering 1,297,872 478,830 who developed AHD. analysis revealed that PLHIV, heterosexual contact was highest AHD, followed by injection use (odds ratio [OR]=0•56, 95% credible interval [CrI] 0•47–0•68), men have (OR=0•54, CrI 0•46–0•63). Regions criminalized had higher risks than those did not. Interpretation Our findings suggest HC is at a compared IDU MSM. This justifies need expand campaigns maintain efforts increase testing population.