Abstract:

HIV Testing Services remain critical as the entry point into HIV prevention and treatment programs. However, retesting of people who already know their HIV-positive status can waste test kits, personnel time, and laboratory resources and pose a retention problem. We estimated retesting rates, reasons, strategies, and re-engagement approaches. We conducted a cross-sectional study in 15 high-volume Health Facilities in Cameroon's West Region, sampling clients aged 15+ who tested HIV positive from April to August 2024. Data collection involved interviews, electronic medical records, and focus groups. Quantitative data was analyzed with SPSS 26; qualitative data with NVivo 14.23.3. A total of 520 adult clients tested HIV positive and 98% consented (n = 509. The mean age was 39 and 58.90% were female (n = 300). This study found a retesting rate of 42.24% (n = 215, p = 0.001). The true positivity rate dropped from 2.44% to 1.43% after we deduplicated the known positives. The most common reason cited was the need to confirm the test results in 87 cases (40.5% p = 0.044). After receiving traditional treatment (30 cases, 14% p = 0.044), some patients returned for repeat testing, while others did so following healing prayers (27 cases, 12.6% p = 0.044). Reengagement in the care of known HIV-positive testers was 95.10%. We found a high rate of retesting, potentially biasing the yearly new HIV diagnoses. HIV testing programs could serve as gateways for re-engaging PLHIV who interrupt treatment, improving care continuity.

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