Objective To analyze the confirmatory results and demographic characteristics of human immunodeficiency virus (HIV) screening-positive samples collected in Xichang City, Sichuan Province from 2019 to 2023, and to provide evidence to inform local HIV prevention and control.

Methods A total of 1 426 HIV screening-positive samples from screening laboratories and testing sites between 2019 and 2023 were confirmed by Western blot (WB) analysis. The confirmed positive rates across different years, characteristics, sample sources, and screening methods were compared, in addition, the WB banding patterns and nucleic acid testing results of the samples were analyzed.

Results Among the 1 426 screening-positive samples, 1 288 (90.32%) were confirmed positive, 38 (2.67%) were indeterminate, and 100 (7.01%) were negative. Among the 1 288 confirmed positive cases, the majority were Yi minority males aged 35‒<50 years with an education level of primary school or below. Initial screening was primarily performed by enzyme-linked immunosorbent assay (ELISA) (62.62%) or rapid diagnostic tests (37.38%). The confirmed positive rate of ELISA was higher than that of rapid diagnostic tests (χ²=24.888, P<0.001). The most frequently observed bands in the confirmed positive samples were gp160 (100.00%), gp120 (100.00%), and p24 (99.30%). In the indeterminate cases, the most frequently observed bands were gp160 (71.05%) and p24 (52.63%). Since 2022, nucleic acid testing (NAT) has been conducted on indeterminate and negative samples. Among the 14 indeterminate samples, six (42.86%) tested positive for viral load, and two confirmed negative cases also showed detectable viral load.

Conclusion In the prevention and control of HIV/AIDS in Xichang City, it is essential to focus on Yi minority males aged 35‒<50 years with an education level of primary school or below. Furthermore, initial screening detection methods should be optimized, and nucleic acid testing should be expanded.