Assessment of the Impact of Gender, Age, Sexual Orientation and PrEP on HIV Infection: Analysis of Anonymous HIV Tests of People in Voluntary Counselling and Testing Points (VCTs) in Poland in 2015-2023.

Human immunodeficiency virus (HIV) is still an important global health burden and remains a common sexually transmitted infection (STI). Voluntary Counselling and Testing points (VCTs) in Poland allow free and anonymous access to HIV testing among the adult population. The aim of the study was to investigate whether there is an increased occurrence of HIV infection among individuals who identify as homosexual and to profile three distinct groups among VCTs clients: the most common patient coming for testing, the most frequent HIV-positive individual, and the most typical Pre-Exposure Prophylaxis (PrEP) user. Data obtained from 29 VCT points in Poland between 2015 and 2023 were retrospectively analyzed. The prevalence of HIV infection in this cohort was calculated and a model for HIV infection risk among various populations was built. 295,556 patient reports revealed that heterosexual men aged 25-34 years (13.43%) tested most frequently. In total, the average prevalence of HIV-positive patients amounted to 1.36%. Among the tested population, HIV infection was the most prevalent among homosexual men aged 25-34 (0.34%). Moreover, we showed that the risk of receiving a positive HIV result was almost five times higher among homosexual and bisexual patients than among heterosexual individuals. The findings highlight the urgent need for targeted HIV prevention efforts, particularly among homosexual and bisexual men. Ongoing monitoring and education are necessary even among PrEP users to prevent new infections.