Correlates of Undiagnosed HIV Infection and Retesting Among Voluntary HIV Testing Clients at Mildmay Clinic, Uganda

• Authors: Avi J Hakim, US Centers for Disease Control and Prevention, Alanta; Barbara Mukasa, Mildmay Clinic; Lee Hundley, US Centers for Disease Control and Prevention, Alanta; Mary Odiit, Mildmay Clinic; Moses Ogwal, Makerere University; Samuel Sendagala, US Centers for Disease Control and Prevention, Kampala; Yvonne Karamagi, Mildmay Clinic; Enos Sande, US Centers for Disease Control and Prevention, Kampala; Wolfgang Hladik, US Centers for Disease Control and Prevention, Atlnta
• Journal Title: AIDS AND BEHAVIOR
• Volume: Volume 23, Number 4
• Publisher: Springer (part of Springer Nature) | 2019-04-01, Pages 820-834
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1007/s10461-018-2274-3
• Subjects: Health Sciences, Public Health
• Keywords: Uganda; HIV testing; HIV retesting; Undiagnosed HIV; Self-interview

Abstract

Increasing HIV diagnosis is important for combatting HIV. We invited individuals aged ≥ 13 years seeking voluntary HIV testing at Mildmay Clinic in Uganda to undertake a computer or audio-computer-assisted self-interview to facilitate post-test counseling. We evaluated first-visit data from 12,233 consenting individuals between January 2011 and October 2013. HIV prevalence was 39.0%. Of those with HIV, 37.2% already knew they were infected. Undiagnosed infection was associated with not being single, screening positive for depression (aOR 1.16, 95% CI 1.04–1.28), and screening for harmful drinking behavior (aOR 1.23, 95% CI 1.10–1.39). The odds of retesting subsequent to HIV diagnosis were lower for males (aOR 0.80, 95% CI 0.70–0.92) and those screening positive for harmful drinking behavior (aOR 0.77, 95% CI 0.66–0.88). Retesting was also associated with higher education and perceived social status below ‘better off’. Our findings reiterate the value of population-based HIV surveys to provide estimates of testing coverage.