TY - JOUR
T1 - HIV retesting prevalence among clients accessing anti-retroviral therapy and HIV testing services in Ghana
AU - Adu-Gyamfi, Raphael
AU - Addo, Stephen Ayisi
AU - Baddoo, Nyonuku Akosua
AU - Kenu, Ernest
AU - Ashinyo, Anthony
AU - Owusu, Kwadwo Koduah
AU - Chihana, Menard Laurent
AU - Adams, Alice Sallar
AU - Magdalene, Odikro
AU - Bandoh, Delia
AU - Abdulai, Marijanatu
AU - Danso, Kenneth
AU - Senya, Kafui
AU - Johnson, Cheryl
N1 - Publisher Copyright:
© 2025 Adu-Gyamfi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2025/2
Y1 - 2025/2
N2 - Introduction Ghana is working towards achieving the 95-95-95 targets for its HIV response. One challenge has been low linkage to care rates, possibly due to high rates of retesting among people living with HIV who are already aware of their status. This leads to an overestimation of the first 95 and a subsequent underestimation of the second 95. This study aimed to measure the prevalence of HIV retesting among PLHIV in Ghana who are already aware of their status and to explore their reasons for retesting. Methods This was a facility-based cross-sectional study conducted in the three ecological zones of Ghana. A total of 11,145 individuals from 30 ART centres and 90 HTS centres participated. The sample size for each zone was determined proportionally based on the number of people enrolled in ART. A profiling tool was used to assess testing behaviours among clients visiting HTS sites linked to ART clinics. Focus group discussions were also conducted with clients and health workers to gather their perceptions of reasons for retesting. Results Participants were predominantly female (74.3%; 8,285/11,145), with a median age (interquartile range) of 43.0 (35–52). The prevalence of retesting among ART clients was 32.9% [95% CI: 0.32–0.34] (3,670/11,145). Among those who retested, the majority did so twice (2,041; 55.6%). Of the clients who tested positive for HIV during the study period, 53.1% (43/835; 95% CI: 0.49–0.57) had a previous HIV diagnosis. Adjusting for retesting, the positivity rate at HTS sites decreased from 8.4% to 4.1%. Key reasons for retesting included the desire to confirm diagnosis, denial and doubt regarding test results, retesting required due to documentation issues, and religious beliefs. Conclusion The prevalence of retesting over the past six years was found to be high, resulting in an overestimation of HIV positivity rates and affecting linkage to care. Implementing interventions to accurately account for retesting instances may improve data accuracy and the country’s linkage to care rate, bringing Ghana closer to achieving the 95-95-95 targets.
AB - Introduction Ghana is working towards achieving the 95-95-95 targets for its HIV response. One challenge has been low linkage to care rates, possibly due to high rates of retesting among people living with HIV who are already aware of their status. This leads to an overestimation of the first 95 and a subsequent underestimation of the second 95. This study aimed to measure the prevalence of HIV retesting among PLHIV in Ghana who are already aware of their status and to explore their reasons for retesting. Methods This was a facility-based cross-sectional study conducted in the three ecological zones of Ghana. A total of 11,145 individuals from 30 ART centres and 90 HTS centres participated. The sample size for each zone was determined proportionally based on the number of people enrolled in ART. A profiling tool was used to assess testing behaviours among clients visiting HTS sites linked to ART clinics. Focus group discussions were also conducted with clients and health workers to gather their perceptions of reasons for retesting. Results Participants were predominantly female (74.3%; 8,285/11,145), with a median age (interquartile range) of 43.0 (35–52). The prevalence of retesting among ART clients was 32.9% [95% CI: 0.32–0.34] (3,670/11,145). Among those who retested, the majority did so twice (2,041; 55.6%). Of the clients who tested positive for HIV during the study period, 53.1% (43/835; 95% CI: 0.49–0.57) had a previous HIV diagnosis. Adjusting for retesting, the positivity rate at HTS sites decreased from 8.4% to 4.1%. Key reasons for retesting included the desire to confirm diagnosis, denial and doubt regarding test results, retesting required due to documentation issues, and religious beliefs. Conclusion The prevalence of retesting over the past six years was found to be high, resulting in an overestimation of HIV positivity rates and affecting linkage to care. Implementing interventions to accurately account for retesting instances may improve data accuracy and the country’s linkage to care rate, bringing Ghana closer to achieving the 95-95-95 targets.
UR - http://www.scopus.com/inward/record.url?scp=85219069992&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0316915
DO - 10.1371/journal.pone.0316915
M3 - Article
AN - SCOPUS:85219069992
SN - 1932-6203
VL - 20
JO - PLoS ONE
JF - PLoS ONE
IS - 2 February
M1 - e0316915
ER -
