截至2024年底，中國的愛滋病疫情呈現明顯的地域差異。根據統計，感染人數排名前十的省份中，四川、廣西和重慶位居前列，且各地的感染特徵與主要風險因素有所不同。

在四川省，截至2024年底累計報告感染人數約為17.47萬例，其中性傳播為主要感染途徑，異性性行為占76.7%，男男性行為占10.8%。四川疫情以涼山州和成都地區最為嚴重，當地的高危性行為及流動人口被認為是主要的傳播因素。由於流動人口密集及性行為防護意識不足，疫情防控面臨巨大挑戰。

廣西壯族自治區累計感染人數達12.32萬例，性傳播途徑占比超過95%。廣西人口多民族聚居，加上旅遊業的發展，增加防控難度。特別是在農村地區，感染率相對較高，其中異性性傳播占比高達86.9%，顯示異性性行為仍然是當地愛滋病傳播的主要方式。

在重慶市，累計報告感染人數約為11.6萬例，性傳播途徑占比高達98.3%。重慶的新發病例中，青年群體及男同性戀者是主要感染群體。然而，2024年重慶的新發病例同比下降2%，顯示部分防控措施開始發揮效果，但值得注意的是，50歲以上中老年感染者的比例顯著上升，顯示疫情呈現老齡化趨勢。

綜合來看，中國各地愛滋病疫情的差異主要受人口流動、性行為模式、多民族聚居及城市與農村差異等因素影響。四川、廣西和重慶的情況反映城市化進程與流動人口增長對疫情傳播的影響，同時也提示各地在防控策略上需針對不同群體採取精準化措施，包括加強青年群體與高危人群的教育、提升防護意識以及針對中老年群體的篩查與干預。

As of the end of 2024, HIV/AIDS in China exhibits significant regional differences, with the highest numbers of reported infections concentrated in certain provinces. The characteristics of infections and the main risk factors vary across regions.

In Sichuan Province, the cumulative number of reported cases reached approximately 174,700. Sexual transmission is the primary route, with heterosexual contact accounting for 76.7% and male-to-male sexual contact accounting for 10.8%. The epidemic is particularly severe in Liangshan Prefecture and Chengdu, where high-risk sexual behaviors and a large mobile population are identified as the main drivers of transmission. The dense population mobility and insufficient awareness of protective measures pose significant challenges to epidemic control.

In the Guangxi Zhuang Autonomous Region, the cumulative number of infections reached 123,200, with sexual transmission exceeding 95% of cases. Guangxi’s multi-ethnic population and the development of the tourism industry have further complicated prevention efforts. Rural areas report relatively higher infection rates, with heterosexual transmission accounting for 86.9% of cases, indicating that heterosexual contact remains the dominant mode of HIV spread in the region.

In Chongqing Municipality, there were approximately 116,000 reported infections, with sexual transmission accounting for 98.3% of cases. Among newly reported cases in 2024, young people and men who have sex with men are the primary affected groups. While new cases decreased by 2% compared to the previous year, there is a notable increase in infections among individuals over 50, highlighting an emerging trend of aging among people living with HIV.

Overall, regional differences in China’s HIV epidemic are influenced by population mobility, sexual behavior patterns, multi-ethnic demographics, and urban-rural disparities. The situations in Sichuan, Guangxi, and Chongqing reflect the impact of urbanization and population movement on the spread of HIV. These trends underscore the need for targeted, region-specific prevention strategies, including enhanced education for young and high-risk populations, improved awareness of protective measures, and screening and intervention programs for middle-aged and older adults.