Determinants of HIV Retesting among People Living with HIV: A Cross-Sectional Study in the Northwest Region, Cameroon

Abstract

Background: Retesters among PLHIV have been on the rise as countries work towards achieving HIV epidemic control. This has potential consequences in HIV programs including delayed ART initiation and duplication of HIV testing data. Context specific assessments are needed to inform mitigation actions. We aimed to assess the reasons and factors associated with HIV retesting among PLHIV. Methodology: This was a cross-sectional mixed methods survey among 800 conveniently sampled PLHIV in four high volume HIV clinics in the Northwest Region from 1 st to 31 st August 2023. We estimated the prevalence of retesting and elicited reasons for retesting. Chi-Square test was used to assess the relationship between retesting and the independent variables and logistic regression analysis in SPSS version 24.0 was used to identify predictors of re-testing. Results: Prevalence of retesting among participants was 26.6% with a higher prevalence observed among PLHIV in the urban setting (32%) compared to those in the rural setting (16%) and 53% of retesters had interrupted treatment in the past. Reasons for retesting included confirmation of cure after prayers 89 (39%), uncertainty about diagnosis 53 (24.9%), health worker request 31 (14.6%), perception of good health 28 (13.1%), confirmation of cure after suppressed viral load 9 (4.2%), premarital VCT 5 (2.3%), and confirmation of cure from alternative treatment 4 (1.9%). In bivariate analysis using chi-square age (p = 0.04), occupation (p = 0.005), level of education (p = 0.019), religion/denomination (p = 0.002) and facility setting (p < 0.001) were significantly associated with retesting. In multivariate analysis younger patients (21 - 40 years) were about 2 times more likely to retest, AOR = 1.9 (95%CI: 1.3, 2.7), while patients using a facility in an urban setting were about 3 times more likely to retest, AOR = 2.7 (95%CI: 1.8, 4.1). Conclusion: Retesting is more likely among younger PLHIV and those living in urban settings. Routine assessments to determine retesters will improve the quality of HIV testing data.