Objective: To analyze the survival status and influencing factors among HIV-infected individuals in Henan Province during different confirmation periods from 1995 to 2023, and to provide a scientific basis for optimizing the "early detection, early treatment" strategy. Methods: The data were derived from the Chinese Information System for Disease Control and Prevention. HIV-infected individuals was divided into four periods based on confirmation period: 1995-2007, 2008-2013, 2014-2016, and 2017-2023. A retrospective cohort study was conducted. The life table method was used to calculate survival probability, the Kaplan-Meier method was used to estimate median survival time and to draw the survival curve; the log-rank test was used to compare differences between groups, and the Cox proportional hazards regression model was used to analyze the influencing factors of survival. Results: Among the 109 520 HIV-infected individuals, the all-cause mortality density was 3.83/100 person-years, the average survival time was 18.30 years, with a median of 22.57 years; the cumulative survival probabilities at 1, 5, 10, 20, and 30 years were 88.23%, 76.81%, 67.68%, 53.35%, and 40.99% respectively; the survival time of those who received antiretroviral therapy (ART) (27.22 years) was significantly more than that of those who did not receive ART (0.75 years, χ2=61 676.44, P<0.001). Multivariate Cox regression showed that male (aHR=1.31, 95%CI: 1.28-1.34), ≥45 years old (aHR=1.67, 95%CI: 1.48-1.88 for 45-59 years old; aHR=2.82, 95%CI: 2.49-3.19 for ≥60 years old), farmer or migrant worker (aHR=1.43, 95%CI: 1.38-1.48), blood transmission (aHR=1.19, 95%CI: 1.16-1.23), no CD4+ T lymphocytes (CD4) counts (aHR=3.49, 95%CI: 3.37-3.61), not receiving ART (aHR=5.22, 95%CI: 5.07-5.38) were risk factors for survival. The mortality risk of married individuals (aHR=0.85, 95%CI: 0.82-0.89) or divorced/widowed individuals (aHR=0.88, 95%CI: 0.84-0.91) was lower than that of unmarried individuals, and having junior high school (aHR=0.90, 95%CI: 0.88-0.93) or senior high school education (aHR=0.66, 95%CI: 0.63-0.69) was associated with lower mortality risk relative to primary school education. The detailed causes of death were mainly cardiovascular and cerebrovascular diseases (23.32%) and malignant tumors (13.04%). Conclusions: With the continuous optimization and popularization of ART strategies, the long-term survival status among HIV-infected individuals in Henan Province has significantly improved from 1995 to 2023. It is necessary to strengthen early detection and early treatment, focus on key populations such as the elderly, farmers, and migrant workers, promote the co-management of HIV infection and chronic non-communicable diseases like cardiovascular and cerebrovascular diseases, and further improve the quality of life. 目的： 分析1995-2023年河南省不同确证时期HIV感染者生存状况及影响因素，为优化“早发现、早治疗”策略提供依据。 方法： 资料来源于中国疾病预防控制信息系统，将HIV感染者按照确证时间分为4个时期（1995-2007年、2008-2013年、2014-2016年、2017-2023年），采用回顾性队列研究方法，运用寿命表法计算生存概率，Kaplan-Meier法分析中位生存时间并绘制生存曲线，log-rank检验比较组间差异，Cox比例风险回归模型分析HIV感染者生存时间的影响因素。 结果： 共有109 520例HIV感染者纳入分析，全死因死亡密度为3.83/100人年，平均生存时间为18.30年，中位生存时间为22.57年；1、5、10、20、30年累积生存概率分别为88.23%、76.81%、67.68%、53.35%、40.99%；接受抗病毒治疗（ART）者中位生存时间（27.22年）明显多于未接受ART者（0.75年，χ2=61 676.44，P<0.001）。多因素Cox比例风险回归模型分析结果显示，男性（aHR=1.31，95%CI：1.28~1.34）、年龄≥45岁（45~59岁：aHR=1.67，95%CI：1.48~1.88；≥60岁：aHR=2.82，95%CI：2.49~3.19）、农民/农民工（aHR=1.43，95%CI：1.38~1.48）、血液传播（aHR=1.19，95%CI：1.16~1.23）、无CD4+T淋巴细胞（CD4）计数检测结果（aHR=3.49，95%CI：3.37~3.61）、未接受ART（aHR=5.22，95%CI：5.07~5.38）是影响HIV感染者生存时间的危险因素，已婚（aHR=0.85，95%CI：0.82~0.89）、离异/丧偶者（aHR=0.88，95%CI：0.84~0.91）的死亡风险均低于未婚，与小学及以下文化程度者相比，初中（aHR=0.90，95%CI：0.88~0.93）、高中及以上（aHR=0.66，95%CI：0.63~0.69）死亡风险较低。死因以心脑血管疾病（23.32%）、恶性肿瘤（13.04%）为主。 结论： 随着ART策略的不断优化和普及，1995-2023年河南省HIV感染者的长期生存状况得到显著改善。需强化早发现、早治疗，关注老年人、农民/农民工等重点人群，推进HIV感染与心脑血管疾病等慢性病的共病管理，进一步提升生存质量。.
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