Changing HIV Epidemiology: A Retrospective Analysis of a Single-Center Experience

In recent decades, the global HIV epidemic has undergone significant changes in transmission patterns, demographics, and clinical outcomes. Understanding regional epidemiological trends is essential for shaping effective public health strategies. This study aimed to evaluate the 20-year epidemiological and clinical trends of people living with HIV (PLWH) followed in a tertiary center in Türkiye.

This retrospective cohort study included PLWH followed at a tertiary hospital between 2005 and 2024. The study period was divided into two decades: 2005-2014 (the first period) and 2015-2024 (the second period). Demographic, clinical, and laboratory data were collected and compared between the two periods.

Of the 160 patients included in the study, 84.4% were male, with a median age of 42 years. A significant increase in new HIV diagnoses was observed in the second period (n=129 vs. n=31). Patients in the second period were younger (median 38 vs. 49 years, p<0.001), more likely to be male (89.1% vs. 64.5%, p=0.002), and more educated (university graduates 29.5% vs. 0%, p<0.001). Although heterosexual transmission remained dominant, an increase in homosexual transmission (17.1% vs. 3.2%) was noted. Clinically, patients diagnosed in the second period had higher median CD4+ T cell counts (451 vs. 231 cells/mm³, p=0.002), a shorter time from diagnosis to treatment (31 vs. 120 days, p<0.001), and a lower prevalence of opportunistic infections (5.4% vs. 19.4%, p=0.02).

The HIV epidemic in this region has evolved significantly over the past two decades. While improvements in early diagnosis and access to treatment reflect public health success, the changing demographics and transmission dynamics highlight the need for targeted prevention strategies. These findings underscore the importance of adapting public health responses to the evolving characteristics of the HIV epidemic.

Graphic Abstract.