Predictors of repeat testing and HIV seroconversion in a sexually transmitted disease clinic population.
OBJECTIVE
This study assessed the extent of and characteristics associated with repeat HIV testing in persons presenting to a sexually transmitted disease (STD) clinic.


METHODS
The study population included all 101 newly diagnosed HIV-infected subjects and 411 matched HIV-uninfected subjects identified over a 5-year period in a publicly funded STD clinic in the southeastern United States.


RESULTS
Of the 508 subjects (99%) with available records, 160 (32%) had tested previously. Age, race, return for posttest counseling, and the client's stated reason for coming to the clinic were associated with repeat testing. Among the 160 subjects who had tested previously, self-identifying as a man who has sex with men or having a history of incarceration was strongly associated with HIV seroconversion (adjusted odds ratio [OR], 51.82; 95% confidence interval [CI], 9.10-295.13; adjusted OR, 83.98, 95% CI, 17.26-408.69, respectively). Presenting for STD-related reasons (STD symptoms or requesting an STD check) had a negative association with HIV seroconversion (adjusted OR, 0.07; 95% CI, 0.01-0.90) compared with presenting for the sole purpose of requesting an HIV test.


CONCLUSIONS
Repeat HIV testing is common among patients receiving services at an STD clinic. The role of repeat testing in HIV prevention efforts is complex and poorly understood. Results from this study could be used to identify and target those testing previously at highest risk for contracting HIV for risk-reduction interventions.
Hightow
Lisa B
LB
Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. lisa_hightow@med.unc.edu
Miller
William C
WC
Leone
Peter A
PA
Wohl
David A
DA
Smurzynski
Marlene
M
Kaplan
Andrew H
AH
D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology; D006679:HIV Seropositivity; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D011897:Random Allocation; D012189:Retrospective Studies