Gonorrhoea in Poland in 2021. / Rzezaczka w Polsce w 2021 roku.

BACKGROUND: The incidence of gonorrhoea at the European level increased over 2012-2019, decreased in 2020, and then reached higher values in 2021 than in 2019. OBJECTIVE: Analysis in the descriptive epidemiology scheme of gonorrhoea notification in surveillance in Poland in 2021 (being the second year of the COVID-19 pandemic). MATERIAL AND METHODS: Case-base data from surveillance of gonorrhoea were used: confirmed case (meeting laboratory criteria), probable (meeting clinical criteria and contact with confirmed case) and possible (only in Poland - physician diagnosed gonorrhoea, no information available for proper classification). Statistic Poland data was used to calculate the indicators. Data on patients treated in dermatology-venereology clinics between 2019-2021 were taken from the Bulletins of the Ministry of Health. RESULTS: The incidence of gonorrhoea in Poland in 2021 was only a fraction of recorded in the EU/EEA (0.74 vs. 13.7/100000)-similar to the first pandemic year and were about half of those notified in the 2019 (the peak year; 281 vs. 522 cases). There were 15.5 men per one female (incidence: 1.6/100000 men, 0.1/100000 women). Every second case was among aged 25-34 (49.62%), every fourth-aged 35-44 (23.11%). Under 15, no cases were reported. The predominant site was the genitourinary (excluding missing data: 85.3%). The cases with missing information on transmision increased (49.1%; aged 45+: 72.0%, women: 76.5%). Delays in reporting data were identified (greater than in 2019, however, less than in 2020), ~17% cases were from 2019-2020. Dermatology-venerology clinics treated 385 people - less than in 2020, however, more than reported in epidemiological surveillance (vs. 281). CONCLUSIONS: The COVID-19 pandemic has influenced on the surveillance system in Poland. There are difficulties in interpreting the epidemiological trend. It is necessary to: 1) intensify systemic solutions in the area of prevention, including sexual partners; 2) raise the awareness of healthcare professionals and sanitary inspection workers on the role of collecting epidemiological information.

HIV infections and AIDS cases in Poland in 2021 year. / Zakazenia HIV i zachorowania na AIDS w Polsce w 2021 roku.

BACKGROUND: Despite a temporary decrease in the number of newly HIV infections in Poland in 2020, a return to the growing number of new infections was observed in 2021 in the surveillance. OBJECTIVE: The aim of the study was to assess the epidemiological situation of newly HIV infections and AIDS cases and death among AIDS cases in Poland in 2021 in comparison to the changes in preceding years. MATERIAL AND METHODS: Analysis of the epidemiological situation was based on reports of newly detected HIV cases and AIDS cases received from doctors and laboratories and the results of the annual survey of HIV testing conducted by laboratories throughout the country. A dataset on clients from Voluntary Testing and Counselling, coordinated by the National AIDS Center, which anonymously collects epidemiological and behaviour data on tested people was used. RESULTS: In 2021 there were 1 367 HIV cases newly diagnosed in Poland (diagnosis rate 3.58 per 100,000), including 236 among non-Polish citizens. The number of HIV infections increased by 43.3% compared to the previous year and was higher by 3.8% compared to the median in 2015-2019 years. Similarly, among VCT clients, number of HIV increased by 45%, from 309 in 2020 to 448 in 2021 year. The total number of AIDS cases reported to surveillance was 62 (incidence 0.16 per 100,000). The HIV infection was most often detected in the age group 30-39 year (35.8%) and among men (82.1%). Among cases with known transmission route, 68.7% concerned among MSM. The percentage of AIDS cases diagnosed at the same time with HIV increased by more than 30 percent points (from 63.5% to 95.1% of all AIDS cases). CONCLUSIONS: In 2021 the number of newly detected HIV infections increased compared to the previous year, probably due to a reduction in restrictions related to the COVID-19 pandemic and increased in HIV testing rate.

Syphilis in Poland in 2020.

PURPOSE: The aim of the study was to assess the epidemiological situation of syphilis cases in Poland in 2020 in comparison to previous years. MATERIAL AND METHODS: Analysis of the epidemiological situation was based on case-based data from reports of newly detected syphilis cases received from doctors and laboratories in 2020. Additionally aggregated data from MZ-56 reports on infectious diseases, infections and poisoning from 2014 to 2018 sent from Sanitary Inspections to NIPH NIH -NRI was used. Also, data about treatment patients in dermatology/venerology clinics in 2020 reported on MZ-14 forms and published in statistics bulletin on Ministry of Health on e-health system website (actually: https://e-zdrowie.gov.pl; https://cez.gov.pl) and NIPH NIH - NRI website were used. RESULTS: In 2020 in Poland 686 newly diagnosed syphilis cases were reported (diagnosis rate was 1.79 per 100,000), including 18 cases among non-Polish citizens. The frequency of newly detected syphilis cases decreased by 54.6% compared to the previous year and similar decreased 52.5% compared to the median in 2014-2018 years. The syphilis cases were most often detected in the age group between 20 and 39 years (68.9%) and among men (86.2%). On the other hand, places where syphilis cases are treated, reported 1,529 cases - less by 4% than in 2019 year, including 979 cases on early stage of syphilis. CONCLUSION: In 2020, the number of reported a newly detected syphilis cases decreased more than by half compared to the previous year, what is probably related to the COVID-19 pandemic and action taken to reduce it. A huge difference in some regions in Poland for diagnosis rates and not visible a significant decrease in the number of treated person, indicate on problem with reporting a newly diagnosed infections, as a main explanation about increasing observed in 2020.

Gonorrhoea in Poland in 2019-2020.

PURPOSE: The aim was the assessment of the epidemiological situation of gonorrhoea in Poland in 2019 and 2020. MATERIAL AND METHODS: Case-based data on gonorrhoea from surveillance were used (to calculate the rate, data from the Statistics Poland on the number of population was used), which were compared with data from previous years. Data on patients treated in dermatology-venereology clinics in 2019-2020 were taken from the Statistical Bulletins of the Ministry of Health. The surveillance definition is: a confirmed case (means meeting the laboratory criteria), probable case (clinical criteria and an epidemiological link - contact with a confirmed case of gonorrhoea) and a possible case (the doctor diagnosed gonorrhoea). RESULTS: Year 2019 was the one with the highest number of reported gonorrhoea cases over the 2014-2020 period - 522 cases and 1.37/100,000 population. In 2020, there was a decrease in cases by 47.13% (246 cases and 0.64/100,000 inhabitants). Delays in reporting were identified - between the diagnosis and the first notification for 2019 and 2020, on average, intervened 36 and 52 days, respectively. On the other hand, in dermatologyvenereology clinics, the number of people treated for gonorrhoea did not change - 448 in 2019 and 442 in 2020. CONCLUSION: 1) The COVID-19 pandemic has deepened the problems of reporting good quality gonorrhoea data in epidemiological surveillance - the planning of appropriate preventive measures in central/local health policies is not possible. Improving surveillance and reporting of complete data on gonorrhoea cases is essential for reliable evaluation of the epidemiological situation. 2) Extensive prophylactic measures should be implemented (including for those under 18 years of age), targeting the source of and to cross routes of infection, including the promotion of safer sexual behaviors and informing the sexual partner.

Changes in HIV testing trends in Poland during COVID-19 pandemic.

INTRODUCTION: At the beginning of COVID-19 pandemic, due to lockdown, limited mobility, as well as changes in the activity profile of some laboratories, the restriction also applied to access to various screening tests, including HIV screening tests. AIM: The aim of the study was to assess HIV testing trend during COVID-19 pandemic in laboratories in Poland and its comparison to the preceding years, with special focus on testing in the network of Voluntary Testing and Counselling (VCT) sites serving population with higher behavior risk, which increase the possibility of HIV infection. MATERIAL AND METHODS: Analysis of the changes in HIV tests number was based on the results of the annual survey of HIV tests conducted among the laboratories throughout the country. The questionnaire included data on screening and positive tests by testing site type, age group and gender. In addition, we extracted data collected in comprehensive National AIDS Centre database, based on epidemiological and behavior data collected by VCT on people who come for testing. RESULTS: There are approximately 400,000 HIV tests annually run in general population in last years. COVID-19 pandemic, which occurred in beginning of 2020 did not have a huge impact on HIV test number among these population, because there was observed 1% decreased. Pandemic COVID-19, due to few lockdown reduced the HIV tests number among VCT clients - population with higher HIV risk infection. Tests number decreased by 44% compare to previous year, due to temporal closed of these centres. Data analysis shows that due to the pandemic, the structure of the surveyed people changed, especially in terms of age and gender, and the place where the study was performed. CONCLUSION: We confirmed low HIV testing rates in general population and low positivity rate over the studied period. The positivity rate was higher in the testing site network targeting individuals engaging in high risk behaviors. Changes observed in HIV testing trends in recent years have been affected by the COVID-19 pandemic.

HIV infections and AIDS in Poland in 2020.

PURPOSE: The aim of the study was to assess the epidemiological situation of newly diagnosed HIV infections and AIDS cases and death among AIDS cases in Poland in 2020 in comparison to the changes in preceding years. MATERIAL AND METHODS: Analysis of the epidemiological situation was based on reports of newly detected HIV cases and AIDS cases received from doctors and laboratories and the results of the annual survey of HIV testing conducted among the laboratories throughout the country. A dataset on clients from anonymous Voluntary Testing and Counselling (VCT) network was also used. The activities of the VCT are coordinated by the National AIDS Center, which anonymously collects epidemiological and behavior data on people who come for testing. RESULTS: In 2020 there were 934 HIV cases newly diagnosed in Poland (diagnosis rate 2.44 per 100,000), including 100 among non-Polish citizens. The number of newly detected HIV infections decreased by 39.9% compared to the previous year and was lower by 26.9% compared to the median in 2014-2018 years. Similarly, among VCT clients, number of HIV diagnoses decreased by 42%, from 536 in 2019 to 308 in 2020 year, what was connected with 44% decreased in number of HIV tests. The total number of AIDS cases was 50 (incidence 0.13 per 100,000). The HIV infection was most often detected in the age group between 30 and 39 (35.7%) and among men (83.5%). Among cases with known transmission route, 68.5% concerned among men who had sexual contact with men (MSM). The percentage of AIDS cases diagnosed at the same time with HIV diagnosis decreased by almost 14 percent points in comparison to 2019 (from 75.8% to 62% of all incident AIDS cases). CONCLUSION: In 2020, the number of newly detected HIV infections decreased compared to the previous year, however, this is not only due to a decrease in the number of infections, but rather to a lack of continuity in the diagnostic and reporting system during the COVID-19 pandemic, as indicated by a smaller number of tests and greater delays in data reporting. Due to the chronic course of HIV infection, a full assessment of the impact of the COVID-19 pandemic will be possible in the future.

Integration of community-based testing data into national HIV surveillance in Poland, Serbia and Slovakia within the framework of INTEGRATE project.

BACKGROUND: Community-based voluntary counselling and testing contributes to early HIV diagnoses among key populations. Testing data from such decentralized services is however often not standardized nor linked to national surveillance systems. This study aimed to support the integration of community testing data into respective national surveillance and monitoring and evaluation systems for those infections. We present results from three national pilots, focused on improved data collection and transfer. METHODS:  Within the Joint Action INTEGRATE different pilot activities were planned and implemented according to the local context. In Slovakia, standardised data collection tools were implemented in three community testing services. The data generated was used to calculate the proposed indicators. In Poland, positive test results from the community testing database were linked to the national case-based surveillance database using confirmatory test number, to improve the completeness of behavioural data in the national database. In Serbia, voluntary counselling and testing forms were improved enabling identification of community-based testing. A system to generate unique client identifiers was initiated in the National registry of HIV cases to monitor linkage to care. RESULTS: All three sites were able to estimate most of the agreed indicators. In Slovakia during the study period 675 people were tested for HIV, 410 for hepatitis C and 457 for syphilis, with reactivity rates of 0.4, 2.5 and 1.8%, respectively. For HIV, 66.7% of reactive cases were confirmed and linked to care. In Poland, 28.9% of the community testing sites' records were linked to the national surveillance database (and accounted for 14.3% of all new diagnoses registered here during 2017-2018). Reactivity rate ranged between 1.9% and 2.1%. In Serbia, 80 persons were tested at community sites, from which two had a reactive HIV test result. By linking unique client identifiers from voluntary counselling and testing and National Registry of HIV cases databases, linkage to care within a two-month period was observed for one of two people with reactive HIV test result. CONCLUSIONS:  Pilot activities in the three countries demonstrate that integration of community-based testing data into surveillance systems is feasible and can help improve national surveillance data by providing key information.

Sexually transmitted infections in Poland in 2013-2018 in comparison to other European countries based on infectious diseases surveillance in Poland and in Europe.

PURPOSE: The aim of the study was to assess the epidemiological situation of newly sexually transmitted infections in Poland in 2013-2018 in comparison to other European countries based on infectious diseases surveillance. MATERIAL AND METHODS: Analysis of the epidemiological situation was based on aggregated data from MZ-56 reports on infectious diseases, infections and poisoning sent from Sanitary Inspections to NIPH NIHNRI. Case-based data for gonorrhoea were analyzed in relation to transmission route and first place of medical diagnosis between 2017-2018. RESULTS: Between 2013-2018 in Poland 8,436 syphilis cases were diagnosed (mean diagnosis rate was 3.66 per 100,000), 2,395 gonorrhoeae cases, whereas number of Chlamydia trachomatis infections from 2014 to 2018 were 1,179 cases. In this time the decrease of 26.2% in newly recognized gonorrhoea cases were observed, whereas the diagnosis rate for chlamydia was stable grew up: from 0.42 per 100,000 in 2014 year to 0.80 in 2018 year. Most STI cases were recognized among men: male to female ratio for syphilis was 5:1, for gonorrhoea 11:1, whereas for chlamydia there is reverse tendency, there are more cases registered among women (0.8:1). CONCLUSION: There are lower STI diagnosis rates in Poland compare to European countries and there are visible big disproportion between number of cases among men and women. Distribution of cases in all voivodeships in Poland and often huge disproportion in the number of new cases between these voivodeships indicate on underreporting problem in Poland.

Syphilis in Poland in 2019.

PURPOSE: The aim of the study was to assess the epidemiological situation of syphilis cases in Poland in 2019 in comparison to previous years. MATERIAL AND METHODS: Analysis of the epidemiological situation was based on case-based data from reports of newly detected syphilis cases received from doctors and laboratories. Additionally aggregated data from MZ-56 reports on infectious diseases, infections and poisoning from 2013 to 2018 sent from Sanitary Inspections to NIPH NIH - NRI was used. Also, data about treatment patients in dermatology/venerology clinics in 2019 reported on MZ-14 forms and published in statistics bulletin on Ministry of Health on e-health system website (actually: https://e-zdrowie.gov.pl; https://cez.gov.pl) and NIPH NIH - NRI website were used. RESULTS: In 2019 in Poland 1,511 syphilis cases were recognized (diagnosis rate was 3.96 per 100,000), including 79 cases among non-Polish citizens. The frequency of newly detected syphilis cases increased by 5% compared to the previous year and was higher by 13% compared to the median in 2013-2017 years. The syphilis cases were most often detected in the age group between 30 and 34 (20.7%) and among men (86.9%). Most cases were recognized among men who have sex with men (42%). CONCLUSION: In 2019, the number of newly detected syphilis cases increased compared to the previous year. Preventive initiatives should be taken, especially among key population as young people, men who have sexual contact with men, and who have risky sexual behaviors. Low syphilis diagnosis rate compared to European countries and a huge difference in some regions in Poland for diagnosis rates indicate on problem with recognition and reporting. To improve the functioning of national surveillance is essential to adequate assessment of epidemiological situation.

HIV infections and AIDS in Poland in 2019.

AIM OF THE STUDY: The aim of the study was to assess the epidemiological situation of newly diagnosed HIV infections, and AIDS cases, and death among AIDS cases in Poland in 2019 in comparison to the changes in preceding years. MATERIAL AND METHODS: Analysis of the epidemiological situation was based on reports of newly detected HIV cases and AIDS cases received from doctors and laboratories and the results of the annual survey of HIV testing conducted among the laboratories throughout the country. A dataset on clients from anonymous Voluntary Testing and Counselling (VCT) network was also used. The activities of the VCT are coordinated by the National AIDS Center, which collects epidemiological and behaviour data on people who come for testing. RESULTS: In 2019 there were 1,551 HIV cases newly diagnosed in Poland (diagnosis rate was 4.04 per 100,000), including 144 among non-Polish citizens. The frequency of newly detected HIV infections increased by 28.2% compared to the previous year and was higher by 21.4% compared to the median in 2013-2017 years. The total number of AIDS cases was 95 (incidence was 0.25 per 100,000) and 15 people died from AIDS disease (0.04 per 100,000 ). The HIV infection was most often detected in the age group between 30 and 39 (36%) and among men (85,1%). Among cases with known transmission route, 73.6% concerned among men who had sexual contact with men (MSM). The percentage of AIDS cases diagnosed at the same time with HIV diagnosis increased by almost 8 percent points in comparison to 2018 (from 73% to 81.1% of all incident AIDS cases). CONCLUSION: In 2019, the frequency of newly detected HIV infections increased compared to the previous year. All actions should be taken to provide medical care to people with newly detected HIV infection, including foreigners residing in Poland. Also HIV testing action should be promoted among total population. Initiatives should be taken to raise awareness of the risk of HIV infection and to disseminate methods of prevention of infection, especially among key populations. It is also advisable to integrate different data sources, the combination of which will allow to improve their quality, as well as reliable monitoring of key epidemiological indicators.

Healthcare professionals' assumptions as barriers to LGBTI healthcare.

Lesbian, gay, bisexual, trans and intersex (LGBTI) people experience significant healthcare inequalities and barriers to healthcare services. Contextualised within six Member States of the European Union (EU), this paper discusses efforts to identify and explore the nature of barriers to healthcare as part of Health4LGBTI, a 2-year pilot project funded by the EU. Data were generated through focus groups and interviews with LGBTI people and healthcare professionals and analysed using thematic analysis. Findings reveal that barriers to healthcare are underpinned by two related assumptions held by healthcare professionals: first, the assumption that patients are heterosexual, cisgender and non-intersex by default; second, the assumption that LGBTI people do not experience significant problems (and therefore that their experience is mostly irrelevant to healthcare). On the other hand, it is notable that responding healthcare professionals were broadly 'LGBTI-friendly'. Thus, we argue that efforts to improve LGBTI healthcare should not be limited to engaging with healthcare professionals with negative views of LGBTI people. Rather, such efforts should also tackle these assumptions amongst LGBTI-friendly healthcare professionals.

HIV and AIDS in Poland in 2018.

AIM: The aim of the study was to assess the epidemiological situation of newly diagnosed HIV infections and AIDS cases and death among AIDS cases in Poland in 2018 in comparison to the changes in preceding years. MATERIALS AND METHODS: Analysis of the epidemiological situation was based on reports of newly detected HIV cases and AIDS cases and the results of the annual survey of HIV testing conducted among the laboratories throughout the country. RESULTS: In 2018 there were 1,209 HIV cases newly diagnosed in Poland (diagnosis rate: 3.15 per 100,000), including 100 among non-Polish citizens. The frequency of newly detected HIV infections decreased by nearly 14.8% compared to the previous year and was higher by almost 6.8% compared to the median in 2012-2016 years. The total number of AIDS cases was 110 (incidence 0.29 per 100,000), and 23 people died from AIDS disease (0.06 per 100,000). New HIV diagnoses were reported mainly among people in age 30 to 39 years (37.8%) and among men (86.8%). Among cases with known transmission route, 77.0% concerned among men who had sexual contact with men (MSM). However, compared to the previous year, there was a significant decrease in the percentage of infected people in all key populations, related to higher risk of HIV infection. In addition, we observe the drop in total number of infected people in 2018 compared to the previous year. Whether these observations represent just fluctuations or a stable tendency, related to decreasing incidence in different key populations can only be assessed in the following years. The percentage of AIDS cases diagnosed at the same time with HIV diagnosis decreased by 4% percent points in comparison to 2017 (from 75.7% to 71.84% of all incident AIDS cases). CONCLUSIONS: Despite the decreasing total number of new HIV diagnoses overall and among different key populations compared to the previous year, it is too early to conclude that these are the results of positive preventive measures. Still, all actions should be taken to ensure timely linkage to care, considering the growing number of infected people among foreigners residing in Poland, and to improve the low frequency of testing towards HIV in the whole population.

A review of lesbian, gay, bisexual, trans and intersex (LGBTI) health and healthcare inequalities.

BACKGROUND: Lesbian, gay, bisexual, trans and intersex (LGBTI) people experience significant health inequalities. Located within a European Commission funded pilot project, this paper presents a review of the health inequalities faced by LGBTI people and the barriers health professionals encounter when providing care. METHODS: A narrative synthesis of 57 papers including systematic reviews, narrative reviews, meta-analyses and primary research. Literature was searched in Cochrane, Campbell Collaboration, Web of Science, CINAHL, PsychINFO and Medline. The review was undertaken to promote understanding of the causes and range of inequalities, as well as how to reduce inequalities. RESULTS: LGBTI people are more likely to experience health inequalities due to heteronormativity or heterosexism, minority stress, experiences of victimization and discrimination, compounded by stigma. Inequalities pertaining to LGBTI health(care) vary depending on gender, age, income and disability as well as between LGBTI groupings. Gaps in the literature remain around how these factors intersect to influence health, with further large-scale research needed particularly regarding trans and intersex people. CONCLUSION: Health inequalities can be addressed via changes in policy, research and in practice through health services that accommodate the needs of LGBTI people. With improved training to address gaps in their knowledge of LGBTI health and healthcare, health professionals should work in collaboration with LGBTI people to address a range of barriers that prevent access to care. Through structural change combined with increased knowledge and understanding, services can potentially become more inclusive and equally accessible to all.

HIV and AIDS in Poland in 2017

AIM: The aim of the study was to assess the epidemiological situation of newly diagnosed HIV infections and AIDS cases and death among AIDS cases in Poland in 2017 in comparison to the changes in preceding years. MATERIALS AND METHODS: Analysis of the epidemiological situation was based on reports of newly detected HIV cases and AIDS cases and the results of the annual survey of HIV testing conducted among the laboratories throughout the country. RESULTS: In 2017 there were 1,419 HIV cases newly diagnosed in Poland (diagnosis rate: 3.69 per 100,000), including 51 among non-Polish citizens. The frequency of newly detected HIV infections increased by nearly 8% compared to the previous year and by almost 28% compared to the median in 2011-2015 years. The total number of AIDS cases was 108 (incidence 0.28 per 100,000), and 20 people died from AIDS disease (0.05 per 100,000). New HIV diagnoses were reported mainly among people in age 20 to 39 years (69.5%) and among men (88.5%). Among cases with known transmission route, 69.5% concerned among men who had sexual contact with men (MSM). The percentage of MSM cases, similarly to heterosexual cases decrease in comparison to previous year, relatively by 5.7% and 6.4%. The percentage of AIDS cases diagnosed at the same time with HIV diagnosis increased by 6% percentage points in comparison with 2016 year (from 68% to 74% AIDS cases). CONCLUSION: The most HIV cases are diagnosed among MSM, so prophylactic activities are still needed in this key population. It is also need to increase the number of new cases linkage-to-care and to improve the low frequency in HIV testing rate in all population.

Genital Chlamydia trachomatis infections in young adults - a school-based bio-behavioural study in urban areas, Poland, 2012 to 2015.

Context and AimOne of the most common sexually transmitted pathogens disproportionately affecting young people is Chlamydia trachomatis (CT). This study aimed to assess prevalence of CT among sexually active students (aged 18-19 years) in their final years of high school education in Warsaw and Krakow. Methods: The sample was selected from 61 clusters, each cluster representing one school. We described city, sex, type of school and their association with CT prevalence. To account for non-responders we applied inverse probability weighting. Results: Our study population consisted of 3,136 young adults eligible for CT screening, of whom 2,326 reported having had sexual intercourse within past 12 months. Of the 950 students who agreed to be tested, 39 were infected with CT. Weighted prevalence of CT was 3.9% (95% confidence interval (CI): 2.7-5.1); however, prevalence in the students in Warsaw (6.6%; 95% CI: 3.5-12.4) was six times higher (prevalence ratio (PR) = 5.9; 95% CI: 2.0-17.3) than in Krakow (1.1%; 95% CI: 0.5-2.6). In both settings, female students attending vocational-technical schools were most affected; the prevalence in this group was more than five times higher (PR = 5.2; 95% CI: 1.7-15.6) compared with female peers in high schools and more than three times higher (PR = 3.3; 95% CI: 1.0-10.7) compared with male peers attending vocational-technical schools. Conclusion: Our study suggested prevalence of CT infection among young people in Poland comparable with the European average, supporting implementation of a CT control programme as recommended in international guidelines.

HIV and AIDS in Poland in 2016

AIM: The aim of the study was to assess the epidemiological situation of newly diagnosed HIV infections and AIDS cases in Poland in 2016 in comparison to the previous years. MATERIALS AND METHODS: Descriptive analysis of the epidemiological situation was based on reports of newly detected HIV cases and AIDS cases and the results of the annual survey of HIV testing conducted among the laboratories throughout the country. Data from the Department of Demographic and Labor Market Research of the Central Statistical Office on deaths due to HIV / AIDS were also used. RESULTS: In 2016 there were 1,313 HIV cases newly diagnosed in Poland (diagnosis rate: 3.42 per 100,000), including 44 among non-Polish citizens. The number of newly detected HIV infections increased by nearly 10% compared to the previous year and by almost 19% compared to the median in 2010-2014. The total number of AIDS cases was 102 (incidence 0.27 per 100,000), and 102 people died of HIV disease (0.27 per 100,000). New HIV diagnoses were reported mainly in men (87.3%) and among people aged 20 to 39 years (71.2%). 81.2% of cases in men with known transmission category concerned men who had sexual contact with men (MSM). CONCLUSIONS: The majority of new HIV cases are diagnosed in the MSM group. However, the assessment of the epidemiological situation is limited by the missing data on the likely route of transmission of newly detected HIV infections.

Socio-demographic Characteristics, Sexual and Test-Seeking Behaviours Amongst Men Who have Sex with Both Men and Women: Results from a Bio-behavioural Survey in 13 European Cities.

Within the MSM population, men who have sex with both men and women (MSMW) are identified as a high-risk group both worldwide and in Europe. In a multi-centred bio-behavioural cross-sectional study, we aimed to assess the relationship(s) between socio-demographic factors, stigma, sexual behavioural patterns, test seeking behaviour and sero-status amongst MSMW. A multi-level analysis was conducted to identify factors associated with being MSMW versus Men who have Sex with Men Only (MSMO). A total of 4901 MSM were enrolled across the 13 study sites. Participants were categorised as MSMW in the 12.64% of the cases. Factors such as educational status, perceived homonegativity, testing facilities knowledge and HIV testing lifetime seem to be relevant factors when characterising the MSMW group. The results highlight the vulnerability of MSMW and the wide spectrum of risky behavioural and psycho-social patterns, particularly in terms of HIV testing, 'outness', and perceived stigma.

HIV serostatus knowledge and serostatus disclosure with the most recent anal intercourse partner in a European MSM sample recruited in 13 cities: results from the Sialon-II study.

BACKGROUND: Knowledge of HIV status can be important in reducing the risk of HIV exposure. In a European sample of men-who-have-sex-with-men (MSM), we aimed to identify factors associated with HIV serostatus disclosure to the most recent anal intercourse (AI) partner. We also aimed to describe the impact of HIV serostatus disclosure on HIV exposure risks. METHODS: During 2013 and 2014, 4901 participants were recruited for the bio-behavioural Sialon-II study in 13 European cities. Behavioural data were collected with a self-administered paper questionnaire. Biological specimens were tested for HIV antibodies. Factors associated with HIV serostatus disclosure with the most recent AI partner were examined using bivariate and multilevel multivariate logistic regression analysis. We also describe the role of serostatus disclosure for HIV exposure of the most recent AI partner. RESULTS: Thirty-five percent (n = 1450) of the study participants reported mutual serostatus disclosure with their most recent AI partner or disclosed having HIV to their partner. Most of these disclosures occurred between steady partners (74%, n = 1077). In addition to the type of partner and HIV diagnosis status, other factors positively associated with HIV serostatus disclosure in the multilevel multivariate logistic regression model were recent testing, no condom use, and outness regarding sexual orientation. Disclosure rates were lowest in three south-eastern European cities. Following condom use (51%, n = 2099), HIV serostatus disclosure (20%, n = 807) was the second most common prevention approach with the most recent AI partner, usually resulting in serosorting. A potential HIV exposure risk for the partner was reported by 26% (111/432) of HIV antibody positive study participants. In 18% (20/111) of exposure episodes, an incorrect HIV serostatus was unknowingly communicated. Partner exposures were equally distributed between steady and non-steady partners. CONCLUSIONS: The probability of HIV exposure through condomless AI is substantially lower after serostatus disclosure compared to non-disclosure. Incorrect knowledge of one's HIV status contributes to a large proportion of HIV exposures amongst European MSM. Maintaining or improving condom use for anal intercourse with non-steady partners, frequent testing to update HIV serostatus awareness, and increased serostatus disclosure particularly between steady partners are confirmed as key aspects for reducing HIV exposures amongst European MSM.

HIV and AIDS in Poland in 2015

AIM: AIM. The aim was to describe the epidemiological situation of newly diagnosed HIV infections and AIDS cases in Poland in 2015 in comparison to the previous years. MATERIALS AND METHODS: Descriptive analysis of newly detected HIV cases and AIDS cases was performed based on routine notifications by clinicians and laboratories. Data on the number of HIV tests from annual survey among laboratories were also used. RESULTS: In 2015 there were 1,281 HIV cases newly diagnosed in Poland (diagnosis rate 3.33 per 100,000 population), including 23 among non-Polish citizens. The rate of new cases rose by 15% compared to the previous year as well as to the median in 2009 - 2013. The total number of AIDS cases was 128 (incidence 0.38 per 100,000) and 41 AIDS patients died (0.11 per 100,000). HIV infection was mainly detected among people aged from 20 to 39 years (71.3%) and among males (84.8%). Among men, 67.6% of newly diagnosed infections with known transmission category were acquired by men who have sex with men (MSM). The percentage of infected men in this group, compared to 2014, increased from 64.5% to 67.6%. The percentage of newly diagnosed persons infected by heterosexual contact decreased from 24.1% to 21.1% (persons with known transmission category). The percentage of people with HIV diagnosed at the same time as AIDS diagnosed decreased in comparison with 2014 (from 9.2% to 6.9% of newly detected HIV infections). CONCLUSIONS: HIV epidemic continues to develop among MSM in Poland. However, assessment of epidemiological situation is limited by the missing data on the probable transmission route in a large percentage of reported newly detected HIV infection.

HIV and AIDS in Poland in 2014

AIM: The aim was to analyze the epidemiological situation of newly diagnosed HIV infections and AIDS cases in Poland in 2014 and years earlier. MATERIALS AND METHOD: Descriptive analysis of newly detected HIV cases and AIDS cases was performed based on routine notifications by clinicians and laboratories. Data on the number of HIV tests from annual survey among laboratories were also used. RESULTS: In 2014 there were 1,157 HIV cases diagnosed in Poland (incidence rate 3.01 per 100,000 population), including 14 among non-Polish citizens. The rate of new cases rose by 4.4% compare to last year and increased by 20% compare to median in 2008 - 2012. The total number of AIDS cases was 148 (incidence 0.38 per 100,000) and 40 AIDS patients died (0.10 per 100,000). HIV infection was mainly detected among people aged 20 to 39 years (72.0%) and among males (82.2%). Among men 64.5% of newly diagnosed infections with known transmission category were acquired by men who have sexual contacts with men (MSM). The percentage of infected men in this group decreased by 4.1% compare to previous year, but there were the increase in the percentage of infected person who take heterosexual contacts, from 20.4% to 24.7% (person with known transmission category). The percentage of late presenters (defined by the time between HIV and AIDS diagnoses of less than 3 months) increased in comparison with year 2013 by almost one percentage (from 8.4% to 9.2% of newly diagnosed HIV infections). CONCLUSIONS: HIV epidemic continues to develop among MSM in Poland. However, assessment of epidemiological situation is limited by the missing data on the probable transmission route in a large percentage of reported newly detected HIV infection.