Global Burden of HIV and Other Sexually Transmitted Infections in Older Men: A Trend Analysis Study

Literature on the trends in the disease burden of HIV and other sexually transmitted infections (STIs) in older men remains sparse. We aim to investigate the burden and trends of these diseases at the global, regional, and national levels.

Data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were used to analyze the age-standardized incidence rate (ASIR) and the age-standardized disability-adjusted life-years rate (ASDR) due to HIV and other STIs in older men. We calculated the average annual percentage change (AAPC) to analyze the 1990-2021 temporal trends.

Globally, the ASIR of HIV in older men showed a downward trend (AAPC, -1.99; 95% confidence interval [CI], -2.11 to -1.86). The ASDR of HIV increased from 1990 to 2004, and then gradually declined after reaching a peak in 2004. The increase in the ASIR of other STIs between 1990 and 2021 was slight (AAPC, 0.07; 95% CI, 0.05 to 0.09) but the ASDR of other STIs decreased substantially (AAPC, -1.42; 95% CI, -1.48 to -1.36). Regionally, Sub-Saharan Africa and Caribbean had the highest ASIR and ASDR of HIV and other STIs. The largest regional-level increase in the ASIR of HIV between 1990 and 2021 was observed in Oceania (AAPC, 10.6; 95% CI, 9.43 to 11.79). Nationally, the trends in the burden of these diseases in older men varied significantly across 204 countries and territories.

Significant advancement has been achieved in alleviating the global burden caused by HIV and other STIs over the past three decades. With population growth and aging, HIV and other STIs in older men remain health challenges worldwide. Our findings are useful for policymakers to understand the epidemiology of these diseases and establish efficient strategies for prevention.