High Percentage of Recent HIV Infection Among HIV-Positive Individuals Newly Diagnosed at Voluntary Counseling and Testing Sites in Poland

Abstract

To gain insight into HIV transmission we estimated the proportion of those recently infected. We examined data from HIV-positive patients and a random 10% sample of HIV-negative patients tested at Voluntary Counseling and Testing sites in Poland in 2006. Archived samples from positive patients were tested by three assays to differentiate recent from long-standing infection. Using logistic regression, we examined the association of recent infection (at least one assay) with age, sex, HIV exposure category, and the interval between self-reported HIV exposure and previous HIV test. Of 13,511 tests, 154 (1.1%) were HIV positive, representing 19.7% (n=783) of new diagnoses in Poland in 2006. Demographic and behavioral data were linked for 95, of whom 45 (47%) were recently infected and 1,001 were HIV negative. New diagnoses were more likely to be injectors (17% vs. 2%), men who have sex with men (MSM) (37% vs. 12%), and less frequent condom users (7.8% vs. 14% always) compared to HIV negatives. The median number of partners during the past 12 months was one and two among positives and negatives, but was higher among MSM-four and three, respectively. Ever injectors were less likely to be recently infected (adjusted OR=0.15, 95%CI=0.03-0.73). Having two or more sexual partners in the past 12 months was an independent predictor of recent infection (4.01, 1.4-11.49). We found no evidence that age or sex predicted recent infection. These data reinforce health education campaigns for safe sex messages, especially among MSM. They also suggest, albeit based on a subset of new diagnoses, that interventions should not be limited to selected age/sex groups.

Increase of new HIV diagnoses among men who have sex with men in Poland, 2000 to 2011

“…Although this increase alone would not fully explain the notification trend, it indicates that an upsurge of new HIV infections may also play a role. To further support the hypothesis of increasing HIV incidence among MSM, other studies found a high proportion (>30%) of recent infections confirmed by recent infection testing algorithm (RITA) testing among new diagnoses among MSM [18,19]. On the other hand, the proportions of respondents in behavioural surveys who reported having ever been tested were comparable in 2004 and 2010, 57% and 62% respectively, although it must be borne in mind that the study designs were different [15,16].…”

Making HIV clinic appointments for clients with positive HIV results at testing sites can improve referral rates

“…9 Negative attitudes toward people reporting risky behavior may be especially harmful and are often seen in medical settings and among medical workers not used to such patients. [10][11][12] Although different venues have been created to increase HIV testing (VCT centers, medical clinics, checkpoints, club testing, home sampling, home testing), no diagnosed individual should be left without referral to HIV clinics, where proper medical care and treatment can be offered. Proper linkage to care helps to achieve both individual and epidemiological goals of reducing the HIV burden and increasing fund efficacy.…”

Rationales for indicator condition-based HIV testing data from the Hospital for Infectious Diseases in Warsaw – one-year observation

“…Nowadays, the tests for the HIV infection are performed in Poland in two ways. First of all, by the carrying out of the programme of the anonymous testing in the Voluntary Counselling and Testing Centres (VCT) (Polish abbreviation: PKD) based on the analysis of the risk factors [22]. This system detects around 1.3% of new HIV infections which indicates its high effectiveness [23].…”