OBJECTIVE: To estimate the prevalence trend and risk factors for anemia in patients with human immunodeficiency virus(HIV) infection receiving antiretroviral therapy(ART) in rural China.METHODS: We conducted cross-sectional studies among the same population in 2010, 2012, and2014, based on data from standard medical record registers. Factors associated with anemia were evaluated using a logistic regression model.RESULTS: The number of patients with HIV infec-tion included in each cross-sectional study was1456 in 2010, 1531 in 2012, and 1567 in 2014, and the prevalence of anemia was 44.3%, 34.7%, and27.6%, respectively. The prevalence of anemia was lower in female patients in 2010 [odds ratio(OR)0.68; 95% confidence interval(CI) 0.55-0.85]; however, there was no difference by sex in 2012(OR0.90; 95% CI 0.72-1.11) and 2014(OR 1.05; 95% CI0.84-1.32). Patients with a higher level of education had a lower risk of anemia in 2014(OR 0.72; 95% CI0.56-0.92), but there was no difference in 2010(OR1.00; 95% CI 0.79-1.25) and 2012(OR 0.99; 95% CI0.79-1.24). Patients who had received a longer duration of ART had a higher risk of anemia in 2014(OR1.74; 95% CI 1.15-2.64), but there was no difference in 2010 and 2012(P > 0.05). Patients receiving Traditional Chinese Medicine(TCM) therapy had a lower risk of anemia.CONCLUSION: The prevalence of anemia among patients with HIV infection receiving ART decreased between 2010 and 2014 in Henan Province but was still higher than the prevalence in the general population of China. TCM therapy can potentially decrease the risk of anemia among patients with HIV infection.