Repeat HIV testing: high-risk behaviour or risk reduction strategy?

Abstract

In this London HIV testing clinic, no significant differences were found in the frequency of UPS between repeat and first-time testers with the exception of gay men with a history of three or more previous HIV tests, who reported elevated levels of high-risk sexual behaviour. For many people, repeat HIV testing has become part of a risk reduction strategy to establish seroconcordance with a regular partner. HIV test counselling provides the opportunity both to address high-risk behaviour and to reinforce personal risk-reduction strategies.

Uso rotineiro do teste anti-HIV entre homens que fazem sexo com homens: do risco à prevenção

“…Some studies defined a "repeat tester" as someone who had tested more than once 22,23 , while others included in this category men who had had three or more tests in their lives 24,25,26,27,28,29 . Since the 2000s, the term "repeat testers" has been replaced by other notions of the frequency of repeat testing, more adequate for the new guidelines on frequent testing for MSM.…”

“…Some authors at the time questioned the effectiveness of counseling to reduce the risk of infection and repeat testing by persons with little risk of infection and who wanted to confirm a negative result 27 . According to some studies, MSM that tested repeatedly were also the ones with the highest risk of HIV infection 22,24,26,27 . According to this line of reasoning, while some authors justified repeat testing based on this high risk of infection, others were concerned about the possible negative effects of this practice.…”

“…According to this line of reasoning, while some authors justified repeat testing based on this high risk of infection, others were concerned about the possible negative effects of this practice. It was argued that successive negative results could reinforce risk behaviors for HIV infection 26,27 . This concern over repeat testing resulted in proposals for interventions and specific counseling strategies for those who had tested more often (more than once lifetime or three or more times), aimed at reducing the risk to these persons through more intense interventions 27 .…”

“…Saúde Pública 2017; 33(4):e00014716 Although backed by different justifications, authors that analyzed repeat testing from a more biomedical perspective and those who considered the importance of community prevention strategies opposed programs that discouraged repeat HIV testing 22,24,25,26,27 .…”

Effective Detection of HIV

“…Although repeat testing may have a secondary effect of decreasing risk behavior (92,105), it also may have a paradoxical effect: repeat negative testing, particularly among youth who repeatedly engage in highrisk behaviors, may foster notions of invulnerability that enable risk behavior (141,142). Gay men with a history of three or more previous HIV tests reported higher levels of risk behavior (42%) than gay men with two or less past tests (25%) (143), which may suggest that repeat testing is used in lieu of behavioral risk reduction among some individuals. Thus, although repeat testing among high-risk persons may help to decrease the time from infection to detection, it should not be promoted as an HIV prevention strategy in itself; repeat testing should incorporate behavioral interventions to reduce risk.…”