HIV-1 Infection Trends in Lower Silesia (2010-2020): A Comparative Analysis of Women and Men and the Urgent Need for Enhanced Screening.

Introduction: Human Immunodeficiency Virus (HIV) remains a major global health issue. In Poland, men represent 79% of the HIV-infected population, but the proportion of women diagnosed has been increasing. This study examines the clinical condition of newly diagnosed HIV-1 patients in Lower Silesia at three key points: 2010, 2016, and 2020, to understand infection dynamics and improve regional screening and prevention efforts.

Objective: The objective of the study is to compare the clinical condition of newly diagnosed women and men with HIV-1 in Lower Silesia at three time points in order to identify trends and differences that can inform targeted public health strategies.

Methods: A retrospective analysis of medical records from the HIV clinic in Wroclaw was conducted for the years mentioned. The dataset included demographic information, transmission routes, clinical status, and co-infections.

Results: The study included 202 patients, of whom 27 were women. Heterosexual transmission was the primary route among women (2010/2016/2020 - 44.44%/57.14%/90.91%), while men predominantly acquired HIV-1 through homosexual contact (2010/2016/2020 - 52.94%/80.82%/75%). A significant decrease in infections from intravenous drug use was observed among men (Chi² = 24.85, df = 2, p < 0.001). Women consistently had lower CD4+ T cell counts, with a median (Q1, Q3) of 250 (108-288), significantly lower than men's 431 (280-550) (Mann-Whitney U-test: z = 4.23, p < 0.001). Women were also more frequently diagnosed as late presenters (OR: 6.07, 95% CI (2.34-15.82)).

Conclusion: This study identifies significant gender disparities in HIV-1 diagnosis in Lower Silesia, with women being six times more likely to be diagnosed as late presenters. This highlights the necessity for enhanced and targeted public health interventions, particularly within the context of antenatal care.