Factors Associated with Commercial or Non-Commercial Contact in Non-Marital Heterosexual Transmission from Chinese HIV/AIDS Case Reporting System in 2018: A Cross-Sectional Study

Abstract Background: In recent years, HIV transmission through heterosexual contact has been on the rise, accounting for more than 69% in 2017{Cui, 2020 #27}. Therefore, an in-depth understanding of the characteristics of heterosexual transmission will greatly improve our effectiveness in preventing AIDS.Methods: All identified People Living With HIV/AIDS (PLWHAs) reported as transmitted through heterosexual transmission in the Chinese HIV/AIDS Case Reporting System (CRS) in 2018 were included in this study. A multivariate logistic regression model was applied to evaluate the relationship between socio-demographic characteristics and the overall risk of being transmitted through commercial heterosexual contact (CHC) or non-marital non-commercial heterosexual contact (NMNCHC).Results: A total of 92026 cases of non-marital heterosexual transmission with no missing data were included in the analysis. There were 40244 (43.73%) cases infected through CHC and 51782 (56.27%) infected through NMNCHC. One year increase in age was associated with 0.98 times the odds of being reported as infected through NMNCHC (aOR = 0.98, 95% CI = 0.9783-0.9806, p < 0.0001), significantly higher odds of infection through NMNCHC was observed with females (aOR = 8.39, 95% CI = 8.03-8.77, p < 0.0001), non-farmers (OR =1.22, 95% CI = 1.18-1.26, p < 0.0001), minorities (aOR = 1.94, 95% CI = 1.86-2.02, p < 0.0001), those with education level of college and above (aOR = 1.49, 95% CI = 1.38-1.61, p < 0.0001), and migrants in the different city of the same province (aOR = 1.28, 95% CI = 1.21-1.34, p < 0.0001). Conclusions: Among heterosexual transmission, Younger people, ethnic minorities, migrants within province, as well as those with comparatively higher socioeconomic status were more likely to be transmitted through non-marital non-commercial heterosexual contact (NMNCHC). More interfere measures and targeted strategies should be made for the HIV transmission through this route.