title: Relating HIV testing patterns in Poland to risky and protective behaviour.
abstract: The aim of the study was to understand HIV testing patterns needed to improve access to early HIV diagnosis, and to investigate the spread of the virus in different populations. We examined prior testing history of individuals presenting for an HIV test across all 30 voluntary testing and counselling sites in Poland, 2008-2010 to determine factors associated with the testing rate using zero-truncated Poisson regression. Of 2397 persons presenting for an HIV test, 25 (1%) were HIV positive and 470 (19.6%) were repeat testers. The proportion of repeat testers was higher among men who have sex with men (MSM) at 37% (90/246), and people who inject drugs (PWID) at 32% (21/65). Higher testing rate was independently associated with exposure category (testing rate ratio, RR for MSM = 2.0, 95% CI 1.6-2.6, and 1.6, 0.9-2.6 for PWID), >5 sex partners (1.9, 1.4-2.7), high-risk partner (1.3, 1.1-1.6), urban residence (2.1, 1.3-3.5) and higher education attainment (1.1, 1.0-1.5). Inconsistent condom use with casual partners and sex under the influence of alcohol were associated with lower testing rates. There is a need to increase HIV testing uptake in Poland, especially among the rural population. Despite testing rates being higher among populations with higher risk of exposure to HIV (MSM and PWID), they still remain low, indicating the existence of barriers to testing.
authors.affiliation: a Department of Epidemiology , National Institute of Public Health - National Institute of Hygiene , Chocimska 24, Warsaw , Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Rosińska
authors.affiliation: b MRC Clinical Trials Unit at University College London , Aviation House 125 Kingsway, London , UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Simmons
authors.affiliation: c National AIDS Centre , ul. Samsonowska 1, Warsaw , Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Marzec-Bogusławska
authors.affiliation: a Department of Epidemiology , National Institute of Public Health - National Institute of Hygiene , Chocimska 24, Warsaw , Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Janiec
authors.affiliation: b MRC Clinical Trials Unit at University College London , Aviation House 125 Kingsway, London , UK.
authors.forename: Kholoud
authors.initials: K
authors.lastname: Porter
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D017280:Condoms / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011044:Poland; D012307:Risk Factors; D012309:Risk-Taking; D012725:Sexual Behavior; D012747:Sexual Partners; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: HIV diagnostic tests; Poland; drug users; men who have sex with men; risk factors; sexual behaviour