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已发表论文
1990-2021年全球、区域及国家育龄妇女性传播感染疾病负担的时间趋势、健康不平等与危险因素分析：基于全球疾病负担研究的分析
Authors Zhang Z, Lei J, Li A, Liang J, Chen S, Li Z, He S, Liu G
Received 9 July 2025
Accepted for publication 10 November 2025
Published 18 November 2025 Volume 2025:17 Pages 4587—4599
DOI https://doi.org/10.2147/IJWH.S552670
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Matteo Frigerio
Zijiao Zhang,1 Jianbo Lei,1– 4 Ailing Li,1 Jun Liang,5– 7 Shanli Chen,1 Zheng Li,8 Songlin He,8 Gordon Liu9
1School of Public Health, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 2Clinical Research Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 3The First Affiliated Hospital, Hainan Medical University, Haikou, Hainan, People’s Republic of China; 4Center for Medical Informatics, Institute of Advanced Clinical Medicine, Peking University, Beijing, People’s Republic of China; 5Department of AI and IT, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 6School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 7National Key Laboratory of Transvascular Implantable Devices, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 8Department of Rehabilitation Medicine & Physical Therapy, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 9Institute for Global Health and Development, Peking University, Beijing, People’s Republic of China
Correspondence: Jianbo Lei, Center for Medical Informatics, Institute of Advanced Clinical Medicine, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, People’s Republic of China, Tel +86(10)8280-5901, Fax +86(10)8280-5900, Email jblei@hsc.pku.edu.cn
Purpose: Sexually transmitted infections (STIs) among women of child-bearing age (WCBA) are a major global public health issue. This study aims to systematically assess the epidemiological burden of HIV and five other major STIs among WCBA worldwide, and analyze their health inequality status and differences of risk factors, so as to help precise prevention and control.
Patients and Methods: Using data from the Global Burden of Disease (GBD) between 1990 and 2021, this research systematically analyzed the disease burden of six major STIs (including HIV, syphilis, chlamydia, gonorrhea, trichomoniasis, and genital herpes) among WCBA (15– 49 years) worldwide by assessing their incidence, mortality, prevalence, and disability-adjusted life years (DALYs). To analyze temporal trends, the Joinpoint regression model was employed to estimate the annual percentage change (APC) and its 95% confidence interval. Health inequalities were quantified using the slope index of inequality (SII) and concentration index (CI). Additionally, risk factors’ contributions to DALYs were assessed by stratifying according to sociodemographic index (SDI) quintiles.
Results: During 1990– 2021, globally, the age-standardized incidence rate (ASIR) of HIV among WCBA showed a combined downward trend (AAPC − 1.94%). Conversely, other STIs exhibited an upward trend (AAPC 0.13%), with the most notable increase from 2015 to 2019 (APC 1.68%). Regionally, Oceania showed the largest HIV ASIR increase, and Western sub-Saharan Africa had the largest increase for other STIs. In 2021, low SDI countries had the highest ASIR for HIV and other STIs. However, high-middle and low-middle SDI countries had the largest increases in ASIR for all STIs. Additionally, health inequality analysis revealed burden differences and inequality in STIs among WCBA.
Conclusion: The global incidence of non-HIV STIs among WCBA increased from 1990 to 2021, with regional variations. Governments and health systems should address social determinants—such as education, poverty, and inequality—to reduce STIs transmission in this group.
Keywords: reproductive health, sexually transmitted infections, women of child-bearing age, health inequalities, global burden of disease
1School of Public Health, Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 2Clinical Research Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 3The First Affiliated Hospital, Hainan Medical University, Haikou, Hainan, People’s Republic of China; 4Center for Medical Informatics, Institute of Advanced Clinical Medicine, Peking University, Beijing, People’s Republic of China; 5Department of AI and IT, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 6School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 7National Key Laboratory of Transvascular Implantable Devices, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People’s Republic of China; 8Department of Rehabilitation Medicine & Physical Therapy, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People’s Republic of China; 9Institute for Global Health and Development, Peking University, Beijing, People’s Republic of China
Correspondence: Jianbo Lei, Center for Medical Informatics, Institute of Advanced Clinical Medicine, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, People’s Republic of China, Tel +86(10)8280-5901, Fax +86(10)8280-5900, Email jblei@hsc.pku.edu.cn
Purpose: Sexually transmitted infections (STIs) among women of child-bearing age (WCBA) are a major global public health issue. This study aims to systematically assess the epidemiological burden of HIV and five other major STIs among WCBA worldwide, and analyze their health inequality status and differences of risk factors, so as to help precise prevention and control.
Patients and Methods: Using data from the Global Burden of Disease (GBD) between 1990 and 2021, this research systematically analyzed the disease burden of six major STIs (including HIV, syphilis, chlamydia, gonorrhea, trichomoniasis, and genital herpes) among WCBA (15– 49 years) worldwide by assessing their incidence, mortality, prevalence, and disability-adjusted life years (DALYs). To analyze temporal trends, the Joinpoint regression model was employed to estimate the annual percentage change (APC) and its 95% confidence interval. Health inequalities were quantified using the slope index of inequality (SII) and concentration index (CI). Additionally, risk factors’ contributions to DALYs were assessed by stratifying according to sociodemographic index (SDI) quintiles.
Results: During 1990– 2021, globally, the age-standardized incidence rate (ASIR) of HIV among WCBA showed a combined downward trend (AAPC − 1.94%). Conversely, other STIs exhibited an upward trend (AAPC 0.13%), with the most notable increase from 2015 to 2019 (APC 1.68%). Regionally, Oceania showed the largest HIV ASIR increase, and Western sub-Saharan Africa had the largest increase for other STIs. In 2021, low SDI countries had the highest ASIR for HIV and other STIs. However, high-middle and low-middle SDI countries had the largest increases in ASIR for all STIs. Additionally, health inequality analysis revealed burden differences and inequality in STIs among WCBA.
Conclusion: The global incidence of non-HIV STIs among WCBA increased from 1990 to 2021, with regional variations. Governments and health systems should address social determinants—such as education, poverty, and inequality—to reduce STIs transmission in this group.
Keywords: reproductive health, sexually transmitted infections, women of child-bearing age, health inequalities, global burden of disease