| dc.description.abstract | Background: Whereas the incidence of HIV has gradually reduced over the past 20 years, promotion of HIV preventive measures such as periodic retesting amongst high-risk populations has become a global priority. WHO recommends that people in high-risk categories retest at least annually after which they are linked to care or prevention services. It is also recommended that at-risk adults who have previously tested negative retest every 3–6 months for benefits including early identification of new infections, receiving ongoing health education on HIV prevention and linkage to posttest service options. Early diagnosis and immediate initiation on treatment (T&T) optimizes clinical outcomes and prevents further spread of HIV. However, there is limited data characterizing the uptake and determinants of HIV retesting among high-risk seronegative individuals.
Purpose: The purpose of this study was to determine the uptake and determinants of HIV re-testing among high-risk seronegative persons in fishing communities of Kasenyi landing site.
Methods: The study adopted a sequential mixed methods design, targeting high risk persons in the fishing communities of Kasenyi landing site. Hotspot mapping and a household survey were conducted, followed by preliminary screening for HIV risk, and finally a purposive sample of eligible participants was selected. Eligible participants were subjected to a structured interview to determine uptake of retesting and its determinants, while key informant interviews were held with HTS service providers to obtain their understanding of the patterns and determinants for HIV retesting among communities serviced by their health facilities. Quantitative data was analyzed in SPSS version 25, while qualitative data was thematically analyzed.
Results: The uptake of HIV re-testing within the previous 6 months, among high-risk sero-negative persons in fishing communities of Kasenyi landing site – central Uganda was 18.5%. Factors associated with an increased likelihood of retesting for HIV included: being female (aPR = 1.89 [CI = 1.059 - 3.380], P = 0.031), being aged between 24-29 years (aPR = 2.59 [CI = 1.154 - 5.79], P =0.021), knowing a relative diagnosed with HIV (aPR = 1.92 [CI = 1.124 - 3.289], P = 0.017), and among individuals who indicated that they visit nearest health facilities for a health checkup even when they are not feeling ill (aPR = 2.49 [CI = 1.540 - 4.011]). However, the uptake of HIV retesting was less by 43% (aPR = 0.57 [CI = 0.369 - 0.887], p= 0.013) among high-risk persons who agreed that their risk of getting infected with HIV was high. The majority of the key informant interviews largely contradicted the quantitative findings obtained regarding the proportion of HIV retesting. Most of the key informants the proportion of HIV retesting of more than 50%, although they all acknowledged that compared to lifetime HIV testing, retesting was less done by high-risk persons at Kasenyi landing site. All the key informants pointed out age and gender as being the most important ones in the context of HIV retesting. The socio demographic factors associated with HIV resting, as put forwards by key informants were related with the findings obtained at the multivariable level, but not the intrapersonal characteristics.
Conclusion: HIV retesting among high-risk persons in fishing communities of Kasenyi landing site is low compared to what is targeted for by the national policy. The HIV retesting behavior is determined by demographic (age and gender) and intrapersonal characteristics (regular checkup, perceived risk, and knowledge of relative diagnosed with HIV), with the latter being comparatively more important. There is therefore need to develop strategies that address the low uptake of HIV retesting specifically targeting males and other high risk groups identified in this study. | en_US |
