Demographic and socio-economic determinants of poor HIV-risk perception at first HIV diagnosis: analysis of the HIV Surveillance data, Italy 2010-2016.

Introduction: HIV infections in Italy has not undergone a substantial decline over recent years. For this reason, we analysed risk-factors and socio-economic indicators of HIV-risk perception in HIV surveillance data.
Methods: An observational study was conducted and HIV-risk perception was estimated on the basis of reasons for undergoing testing. Ordinal logistic models were applied with three groups of response corresponding to three ordered levels of HIV-risk perception.
Results: The study included 18 055 individuals: 27% with low, 40% moderate and 33% with high perception. A low risk perception was estimated in both areas, least deprived and highly deprived [Adjusted Odds Ratio (AOR) = 1.58, CI: 1.14-2.18 and AOR = 2.33, CI: 1.39-3.90]; for heterosexuals (AOR = 1.96, CI: 1.83-2.11), Injecting Drug Users (IDU) (AOR =1.82, CI: 1.59-2.08), low education (AOR = 1.74. CI: 1.20-2.54), age > 40 years (AOR = 1.59, CI: 1.50-1.69), males (AOR = 1.30, CI: 1.20-1.40).
Conclusions: In Italy there is a high percentage of HIV-infected people with poor HIV-risk perception. Poorer HIV-risk perception was associated with both, least and high deprivation, low education, older age, male gender, heterosexual and IDU groups. Our results could be relevant to address targeted HIV testing policies at both local and national levels.