Title: Behavioral and socio-demographic determinants of HIV, syphilis and HCV infections among VCT clients in Poland in 2015-2025, including the war refugee population from Ukraine
Abstract:
Background: Large migration flows from Ukraine (a country with one of the highest HIV/STI infection rates in Europe) to European countries, mainly to Poland, elevates the risk of an increase in the number of HIV and STI infections. Ukraine has the second-largest HIV epidemic in Europe (HIV prevalence in general population approx. 1%) with most new cases occurring through heterosexual transmission and injecting drug use. Ukrainian citizens represent a significant group of ART patients in Poland (3590 persons as of Dec 31, 2025) and clients of the 28 voluntary counselling and testing centers (PKD/VCT). Since the outbreak of the war in Ukraine, above 50 million crossings in both directions of the Polish-Ukrainian border have been recorded. The study aims at identifying risk factors and behavioral and socio-demographic determinants (age, gender, sexual orientation, sexual practices) of HIV, syphilis and HCV infection in the Polish and Ukrainian populations visiting the VCTs (PKD).
Methods: Data obtained from Polish VCT centres through online surveys with VCT clients (Polish, Ukrainian) aiming at identifying risk factors associated with their sexual behaviour and socio-demographic characteristics. For analyzing data, the quantitative analysis of variables and descriptive statistics as well as the Tau-b-Kandall ch2 statistical measure were used. During data analysis the main emphasis was laid on data from January 1, 2022 to June 30, 2025 to allow comparing the occurrence of the given characteristics in both Polish and Ukrainian citizens (Ukrainians who came to Poland after the outbreak of the war in Ukraine in February 2022).
Data collection: The time interval examined: January 1, 2015 to June 30, 2025 (for Poles) and January 1, 2022 to June 30, 2025 (for Ukrainians). Total of 354,162 HIV tests performed in VCT sites (4,754 positive results, 1.34%); 3,123 HCV screening tests (587 positive, 18.79%) and 82,016 syphilis tests (2,257 positive, 2.75%). For Ukrainians: 5,538 HIV tests (277 positive results, 5%), 3,575 HCV screening tests (78 positive, 2.18%) and 3,547 syphilis tests (118 positive, 3.33%). During their visit in VCTs a standardized interviews have been conducted with the clients to identify socio-demographic characteristics of the reporting individuals.
Results: Statistical analysis of socio-demographic and behavioral variables indicates different significance of risk factors in the population of Poles and Ukrainians. In both groups, the likelihood of getting tested for HIV increases with age. And also the older a person, the more likely positive HIV test result. Observed increasing percentage of women as well as gay and lesbian clients visiting VCTs. Depending on the sexual practice (oral, anal, vaginal sex), the use of condoms declines or remains low in both Polish and Ukrainian clients. In addition declines the percentage of clients having sex after using injecting drugs and alcohol. However, the use of other psychoactive substances remains relatively high. Other factors observed: declining number of HIV-positive partners among VCT clients. HIV/STI infection mainly as a result of unprotected sexual contacts between men (Polish clients) and as a consequence of unprotected heterosexual contacts (Ukrainian clients).
