“In the past, when we talked about sexually active populations, we mainly referred to people aged 20 to 49, who accounted for the majority of HIV infections. But now, infection rates among people aged 50 and above are increasing.” On December 1, during a World AIDS Day themed publicity event jointly organized by Guangdong Province and Guangzhou City, Han Zhigang, Director of the HIV Prevention and Control Department at the Guangzhou Center for Disease Control and Prevention, said this in an interview with Yicai.

Recently, several regions have successively disclosed data on HIV infections/AIDS cases among older adults.

Fu Xiaobing, Director of the HIV Prevention and Control Institute at the Guangdong Provincial Center for Disease Control and Prevention, noted that the HIV epidemic in Guangdong shows four main characteristics: First, the overall epidemic remains at a low prevalence level across the province; Second, the regional distribution is uneven; Third, sexual transmission is the dominant route of infection; and fourth, the proportion of cases among older age groups continues to rise.

Data released by Guangdong also show that the proportion of reported cases among older age groups (approximately ≥60 years) increased from 12.4% in 2015 to 20.1% in January–October 2025.

Data from Zhejiang Province similarly indicate that among newly reported cases this year, middle-aged and older adults aged 50 and above accounted for 39.2%. Zhang Xinwei, Director and Deputy Party Secretary of the Zhejiang Provincial Center for Disease Control and Prevention, stated that HIV prevention and control in Zhejiang currently faces multiple challenges, including a relatively high infection rate among men who have sex with men, a large number of heterosexually transmitted infections with strong concealment, a continuous increase in infections among middle-aged and older adults, and insufficient awareness of voluntary testing.

Han Zhigang explained that HIV infections among young students are mainly transmitted through male-to-male sexual contact. Although this group generally has a good understanding of HIV-related knowledge, there is often a gap between knowledge and behavior, with a tendency toward risk-taking and optimism bias. In contrast, older adults infected with HIV usually have weaker awareness of HIV prevention, lower levels of education, and are predominantly infected through heterosexual transmission.

A study published in 2023 in the Chinese Journal of Epidemiology, titled “The Current Status and Challenges of HIV/AIDS Prevention and Control Among Older Adults in China”, showed that the number of newly reported HIV infections among people aged ≥50 has been increasing annually, rising from 32,900 cases in 2015 to 51,900 cases in 2020. Among them, the number of HIV infections in people aged ≥60 increased from 17,500 in 2015 to 27,000 in 2022, mainly concentrated in certain provinces in Southwest and South China where the HIV epidemic is more severe.

The study also pointed out that HIV prevention and control among older adults face new challenges. Older populations generally have a low perception of HIV infection risk and a relatively high proportion of unprotected casual or commercial sexual behaviors, resulting in elevated infection risk. Older people living with HIV, as well as older adults at high risk of infection, tend to have lower levels of education and socioeconomic status, limited access to HIV-related knowledge and testing services, and significantly higher mortality risk due to late diagnosis and the presence of comorbid chronic diseases.

To interrupt HIV transmission, early detection, viral suppression, reduction of onward transmission, and encouragement of screening among high-risk populations are essential. How to move HIV prevention and control for older adults further upstream has therefore become a key concern.

In October this year, the General Office of the Guangdong Provincial People’s Government issued the Guangdong Action Plan for Curbing and Preventing HIV/AIDS (2025–2030). The plan clearly states that over the next five years, Guangdong will implement six major actions—health education and behavioral interventions, surveillance and testing, treatment and assistance, prevention among key populations, targeted efforts in key regions, and comprehensive social governance—to keep the provincial HIV epidemic at a low prevalence level and strive to achieve an overall population infection rate of ≤0.2% by 2030.

According to Fu Xiaobing, Guangdong’s HIV surveillance and testing network has continued to improve. As of October 2025, the province had established 3,013 HIV testing laboratories, a 26.6% increase compared with 2020. The nine cities in the Pearl River Delta have preliminarily acquired molecular biological testing capabilities. Province-wide, 114 active surveillance sentinel sites covering seven categories of high-risk and key populations have been set up. Voluntary counseling and testing (VCT) clinics increased from 458 in 2020 to 487 by October 2025.

Notably, Guangdong’s first community-based HIV pre- and post-exposure prophylaxis clinic—the HIV Exposure Prevention Clinic at the Yuncheng Street Community Health Service Center in Baiyun District, Guangzhou—officially opened in August this year. It has established a closed-loop, full-process management system covering “education–intervention–testing–referral–treatment–follow-up.”