{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:17:41Z","timestamp":1789586261304,"version":"build-2803163510"},"reference-count":22,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2017,11,1]],"date-time":"2017-11-01T00:00:00Z","timestamp":1509494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Assoc Provid AIDS Care"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:p>\n                    Repeat HIV testing after receiving a positive result has never been studied systematically and may give insight into reasons for delayed linkage to care. Among 831 adults in 6 secondary facilities in Oromia, Ethiopia, who completed an interviewer-administered structured questionnaire within 2 weeks of initiating antiretroviral therapy in 2012 to 2013, 110 (13.2%) reported having retested after an HIV-positive result. The odds of repeat (versus single) HIV-positive testing were higher among those who had doubted their HIV status (adjusted odds ratio [AOR]\n                    <jats:sub>ref=nodoubt<\/jats:sub>\n                    = 6.5; 95% confidence interval [CI]: 3.7-11.4) and those who initially tested at another facility, whether another secondary facility (AOR\n                    <jats:sub>ref=studyfacility<\/jats:sub>\n                    = 22.7; 95% CI: 11.0-46.9) or a lower-level facility (AOR\n                    <jats:sub>ref=studyfacility<\/jats:sub>\n                    = 19.1; 95% CI: 10.5-34.5). The odds of repeat (versus single) HIV-positive testing were lower among those who initially tested because of symptoms (AOR\n                    <jats:sub>ref=not a reason<\/jats:sub>\n                    = 0.40; 95% CI: 0.24-0.66). Median time between initial diagnosis and enrollment in care was 12.3 versus 1.0 month for repeat and single HIV-positive testers, respectively ( P &lt; .001). Repeat HIV-positive testing\u2014not a rare occurrence\u2014appears to stem from doubt, seeking care at a facility other than where diagnosed, and testing for a reason other than having symptoms. Because repeat HIV-positive testing is associated with delay in linkage to care, providers should be aware of this potential when counseling those who test HIV positive.\n                  <\/jats:p>","DOI":"10.1177\/2325957417737840","type":"journal-article","created":{"date-parts":[[2017,11,9]],"date-time":"2017-11-09T03:39:56Z","timestamp":1510198796000},"page":"546-554","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["\u201cTesting, Testing\u201d: Multiple HIV-Positive Tests among Patients Initiating Antiretroviral Therapy in Ethiopia"],"prefix":"10.1177","volume":"16","author":[{"given":"Sarah","family":"Kulkarni","sequence":"first","affiliation":[{"name":"CUNY Graduate School of Public Health and Health Policy, New York, NY, USA"},{"name":"CUNY Institute of Implementation Science in Population Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Tymejczyk","sequence":"additional","affiliation":[{"name":"CUNY Graduate School of Public Health and Health Policy, New York, NY, USA"},{"name":"CUNY Institute of Implementation Science in Population Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsigereda","family":"Gadisa","sequence":"additional","affiliation":[{"name":"ICAP-Columbia University, Mailman School of Public Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Lahuerta","sequence":"additional","affiliation":[{"name":"ICAP-Columbia University, Mailman School of Public Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Remien","sequence":"additional","affiliation":[{"name":"HIV Center for Clinical and Behavioral Studies, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zenebe","family":"Melaku","sequence":"additional","affiliation":[{"name":"ICAP-Columbia University, Mailman School of Public Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaa","family":"El-Sadr","sequence":"additional","affiliation":[{"name":"ICAP-Columbia University, Mailman School of Public Health, New York, NY, USA"},{"name":"Mailman School of Public Health, Columbia University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Batya","family":"Elul","sequence":"additional","affiliation":[{"name":"ICAP-Columbia University, Mailman School of Public Health, New York, NY, USA"},{"name":"Mailman School of Public Health, Columbia University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Nash","sequence":"additional","affiliation":[{"name":"CUNY Graduate School of Public Health and Health Policy, New York, NY, USA"},{"name":"CUNY Institute of Implementation Science in Population Health, New York, NY, USA"},{"name":"HIV Center for Clinical and Behavioral Studies, New York, NY, USA"},{"name":"Mailman School of Public Health, Columbia University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susie","family":"Hoffman","sequence":"additional","affiliation":[{"name":"HIV Center for Clinical and Behavioral Studies, New York, NY, USA"},{"name":"Mailman School of Public Health, Columbia University, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,11,9]]},"reference":[{"key":"bibr1-2325957417737840","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit724"},{"key":"bibr2-2325957417737840","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000427"},{"key":"bibr3-2325957417737840","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-013-0158-8"},{"key":"bibr4-2325957417737840","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e31827e612b"},{"key":"bibr5-2325957417737840","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2006.096263"},{"key":"bibr6-2325957417737840","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-220"},{"key":"bibr7-2325957417737840","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318298721b"},{"key":"bibr8-2325957417737840","doi-asserted-by":"publisher","DOI":"10.1177\/1557988312468146"},{"key":"bibr9-2325957417737840","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.19.1.20637"},{"key":"bibr10-2325957417737840","volume-title":"Health 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