AimsThe aims of the project were: (1) to map the current HIV-HCV co-infection in Liangshan Prefecture, Sichuan Province, China, (2) to explore the risk factors of HIV-HCV co-infection in Liangshan Prefecture, and (3) to propose strategies for prevention and control of HIV-HCV co-infection in Liangshan Prefecture.Subject and methodsThis study assessed the HIV-HCV co-infection rate, characteristics, and correlative factors of HIV-HCV co-infection individuals reported between 2018 and 2022 in Liangshan. This made use of path analysis, multiple logistic regression analysis, and chi-square tests.ResultsThe findings revealed a 6.75% HIV-HCV co-infection rate, and the incidence was stable from 2018 to 2022. The outcomes of multiple logistic regression showed the correlative factors, including male (OR = 2.640, 95% CI: 2.300-3.031), 25-44 years (OR = 4.184, 95% CI: 2.135-8.196), 45-64 years (OR = 3.411, 95% CI: 1.733-0.937), Anning River Valley (OR = 2.583, 95% CI: 1.833-3.639) and east of it (OR = 2.543, 95% CI: 1.749-3.699), and injecting drug use (OR = 2.116, 95% CI: 1.879-2.383). The pathway analysis revealed that co-infection was directly influenced by gender (-0.112), ethnicity (-0.079), marital status (0.077), and route of infection (-0.095).ConclusionConcentrate on the high-risk group based on the co-infection associated factors found in the study's findings. Take the necessary steps to enhance patient quality of life and survival, as well as the efficacy of preventive treatment and therapy.