Reasons for, and factors associated with, positive HIV retesting: a cross-sectional study in Eswatini

ABSTRACT

Eswatini has a high HIV prevalence but has made progress towards improving HIV-status awareness, ART uptake and viral suppression. However, there is still a delay in ART initiation, which could partly be attributed to positive HIV-retesting. This study examines reasons for, and factors associated with, positive HIV-retesting among MaxART participants in Eswatini. Data from 601 participants is included in this cross-sectional study. Descriptive statistics and logistic regressions were used. Of the participants, 32.8% has ever retested after a previous positive result. Most participants who retested did this because they could not accept their results (61.9% of all retesters). Other main reasons are related to external influences, gender or the progression of their HIV infection (respectively 18.3%, 10.2%, and 6.1% of all retesters). Participants without a current partner and participants with less time since their first positive test have lower odds of retesting. To decrease retesting and reduce the delay in ART initiation resulting from it, efforts could be made on increasing the acceptance of positive HIV results. Providing more information on the process of testing and importance of early ART initiation, could be part of the solution.

KEYWORDS:

• HIV
• retesting
• repeat testing
• test-and-treat
• Eswatini

Acknowledgements

We thank everyone who contributed to the execution and data collection of the MaxART trial and the social science component. We also thank the MaxART partners, study team, healthcare providers and patients at study sites for their cooperation during the study.

Disclosure statement

The MaxART consortium received support of the Dutch Postcode Lottery in the Netherlands, the Embassy of the Kingdom of the Netherlands in South Africa/Mozambique, British Colombia Centre of Excellence in HIV/AIDS in Canada, Mylan and Médecins Sans Frontières. The findings and analysis presented are those of the authors and do not reflect those of any funders.

Additional information

Funding

The MaxART consortium received support of the Dutch Postcode Lottery in the Netherlands, the Embassy of the Kingdom of the Netherlands in South Africa/ Mozambique, British Colombia Centre of Excellence in HIV/AIDS in Canada, Mylan and Médecins Sans Frontières.