To compare the characteristics of HIV/AIDS cases detected through medical institutions and voluntary counseling and testing (VCT) clinics in Liaoning province, China, from 2018 to 2024.

Data on newly reported HIV/AIDS cases, follow-up information, and HIV testing volumes from 2018 to 2024 were extracted from the AIDS Comprehensive Prevention and Control Information System of the Chinese Center for Disease Control and Prevention. Demographic and clinical characteristics of cases from the two detection channels were compared using the chi-square test. Trends in crude detection rates were analyzed using Joinpoint regression to calculate the average annual percent change (AAPC).

From 2018 to 2024, 9 314 and 4 657 HIV/AIDS cases were detected through medical institutions and VCT clinics, respectively. Both channels showed significant declining trends in crude detection rates (medical institutions: AAPC = –5.78%, P = 0.036; VCT clinics: AAPC = –12.38%, P = 0.009). Significant differences (P < 0.001) were observed in all demographic characteristics (gender, age, education, marital status, occupation). Cases from medical institutions were predominantly male (89.50%), aged 20–39 years (51.21%), had a junior high school education or below (46.17%), and were infected via male-to-male sexual contact (59.30%). In contrast, cases from VCT clinics had a higher proportion of males (94.09%), were younger (63.62% aged 20–39), had a higher education level (44.56% with college or above), and a greater proportion were infected via male-to-male sexual contact (78.48%). A stark contrast was noted in the initial CD4⁺ T lymphocyte count: 44.07% of cases from medical institutions had a count < 200 cells/μL, whereas 42.97% from VCT clinics had a count ≥ 350 cells/μL (P < 0.001).

Significant differences exist in the characteristics of HIV/AIDS cases detected through medical institutions and VCT clinics in Liaoning province. Medical institutions serve as the primary case detection channel, while VCT clinics play a crucial role in identifying cases at an earlier disease stage. Public health strategies should leverage the complementary advantages of both approaches to promote early HIV testing and case detection.