BACKGROUND: HIV testing is necessary for identifying and linking individuals with undiagnosed HIV infection to HIV care and prevention services to increase survival and reduce HIV transmission. However, some individuals choose to retest at a publicly-funded Counseling, Testing, and Referral (CTR) facility after their initial HIV diagnosis. We aimed to characterize these repeat testers to better understand their reasons behind receiving additional HIV testing.
METHODS: A dataset of positive HIV tests with a date of contact (i.e. date specimen was collected) from 2012-2016 was generated from EvaluationWeb for linkage with the enhanced HIV/AIDS Reporting System (eHARS). Tests were categorized as repeat tests if the date of contact was ≥ 1 day after the earliest diagnosis date in eHARS. We compared demographics and behavioral risk categories of repeat tests and those representing new diagnoses. We also examined self-reported previous HIV test result at the time of repeat testing. Statistical significance was calculated using chi-square and Fisher’s exact tests. We further evaluated HIV care status and viral suppression (<200 copies/mL) at the time of and after the first repeat test using laboratory data in eHARS.
RESULTS: Of 318 positive results, 216 (68%) represented new diagnoses and 102 (32%) represented individuals who had been diagnosed previously. While 101 individuals had 1 repeat test, one person had 2 repeat tests. Race was the only significant factor associated with repeat testing: non-Hispanic Blacks made up 68% of the previously diagnosed but only 49% of the newly diagnosed (p=0.02). Approximately 30% of repeat testers reported that their previous HIV test result was negative at the time of receiving additional CTR tests. Almost half (48%) of repeat testers had evidence of HIV care within the 12 months prior to their first repeat test. Of those with recent care, 53% were virally suppressed at their last viral load test, 29% were unsuppressed, and 18% had no documented viral load. Of those with no evidence of prior or recent care, 79% were linked to care within 3 months of their repeat test, and another 6% were linked within 12 months.
CONCLUSIONS: Having repeat positive HIV tests may be an approach to validating HIV diagnosis or (re)engaging in HIV care, particularly among non-Hispanic Black men in Wisconsin. To avoid potentially unnecessary repeat HIV testing, it is important for CTR and clinical providers to effectively communicate about previous test results, linkage and retention in HIV care, and viral suppression with individuals who are HIV-positive.