Returning for HIV Test Results: A Systematic Review of Barriers and Facilitators

Table 1

Characteristics of the studies.

Reference (short)	Country	Aim	Population	Outcomes delay	Sample ()	Study design	FTR/return rate	Factors significantly associated with FTR/return
Slutsker et al. (1992) [12]	USA	Assess the extent of and characteristics associated with FTR for posttest counseling in individuals seeking HIV	General population	30 days	9,644	Cross-sectional	24% failed to return for their test results	Being tested at non-HIV clinic; Being aged 10–29 years; Blacks; Recent IVDU; Individuals choosing confidential testing
Wimonsate et al. (2011) [13]	Thailand	Evaluate factors associated with HIV testing history and returning for HIV test results	Men who have sex with men (MSM)	7 days for a maximum of 3 months	2,409	Cross-sectional	24.9% returned to receive the test results	Being classified as MSW; Older age (≥29); Lacking a family confidant; Self-reported history of STI; Testing HIV-negative
Bergenstrom et al. (2007) [14]	Vietnam	Assess factors associated with return to posttest counseling	Injecting drug users (IDUs)	Not mentioned	309	Cross-sectional	54% returned to receive the test results	Residence in Bac Ninh town centre (urban district)
Catania et al. (1990) [15]	USA	To examine social, demographic, and psychological predictors of people who fail to return for their test results	General population	Not mentioned	1,007	Cross-sectional	28% failed to return for their results	HIV test knowledge; AIDS anxiety; Education; Age at the moment of blood transfusion
Desai and Rosenheck (2004) [16]	USA	To determine the rates and predictors of HIV testing and receipt of results among homeless adults with serious mental illness in the initial 3-month period after contact with a community-based case management program	Homeless persons with serious mental illness	3 months	2,135	Longitudinal/cohort	Among those tested, 88.8% reported receiving their test results	Positive association with: Level of education; Negative association with: Being disabled; Outpatient medical service utilization; Having a sexually transmitted disease other than HIV; Drug problems at baseline; Worsening drug problems over the course of follow-up; Frequency of HIV testing during follow-up; Prior testing history
Dinh et al. (2005) [17]	Vietnam	To identify the factors associated with declining HIV testing and the failure to return for results	Pregnant women	Not mentioned	266	Cross-sectional	55.3% returned for their results	Educational level below the 12th grade
Ellen et al. (2004) [18]	USA	To determine the posttest counselling (PTC) rates for HIV-infected and uninfected individuals receiving HIV counselling and testing on a mobile STD/HIV screening clinic and to determine whether individuals at highest risk for transmitting their infection were less likely to receive PTC than those at lower risk for transmitting	HIV-positive individuals; HIV-negative individuals	14 days	2,022	Cross-sectional	66% (infected), 46% (not infected) returned for their results	Among not infected: (i) Being female; (ii) Drug treatment in last 3 months; (iii) Engaged in sex work over 3 months ago; (iv) Having engaged in sex work in last 3 months; Among infected: (i) Drug treatment in last 3 months
Erbelding et al. (2004) [19]	USA	To analyse data on STD clinic patients undergoing HIV testing between who tested HIV-negative to describe characteristics associated with “nonreturn” for results	HIV-negative individuals	1 week	31,777	Retrospective cross-sectional	48% returned for their results	Age < 30; Reason for initial test visit (HIV testing, STD symptoms, contact to STD, STD test positive, check-up); Risk behaviours (ever had same sex contact, ever used injection drugs, ever used inhaled cocaine, ever exchanged sex for money/drugs, ever had sex partner who used injection drugs, ever had sex partner with HIV/AIDS, ever had partner who exchanged sex for money/drugs, ≥ two partners, past month); STD at test visit (gonorrhea, syphilis, other STD)
Healey et al. (2010) [20]	Australia	To assess the proportion of patients who returned for HIV results and factors predicting return	General population	Within 4 weeks	159	Retrospective cross-sectional	45% returned for their results	Male gender; Attending the men-only outreach clinic; Having a first HIV test at the clinic; Having sex overseas in the past year
Hightow et al. (2003) [21]	USA	To assess the prevalence and predictors of receiving HIV test results	General population	2 weeks later	508	Retrospective cohort	55% (overall) failed to return for test result	HIV testing history; STD diagnosis (HPV); Demographic characteristics (black race)
Hong et al. (2011) [8]	Vietnam	To assess whether this program was reaching its targeted populations and examined factors that influenced their service utilization	General population	1 week	158,888	Retrospective cross-sectional	3.5% indicated failure to return for test results	Clients from the Central Highlands provinces; Those who were referred by peer educators; Those reporting no receipt of prior test results
Kinsler et al. (2007) [22]	USA	To examine time trends of FTR for HIV test results among a mobile van population in Los Angeles	General population	7 days	7,724	Retrospective cross-sectional	FTR by years were as follows: 18% (1997); 24% (1998); 28% (1999); 37% (2000); 43% (2001); 37% (2002); 41% (2003); 35% (2004)	Those testing positive; Women; Black; Latino; Those older than 20 years of age
Laanani et al. (2015) [10]	France	To assess factors associated with FTR for HIV test results in a free and anonymous screening centre (CDAG) in Paris	General population	3 days after the blood sampling	710	Cross-sectional	6.5% (overall) failed to return	People who did not specify their birthplace; People who were living outside of the Paris region; Having sex with 6 partners or more during the last year; Reporting visiting for clinical symptoms; Having absolutely no self-perceived risk; Having a higher self-perceived risk
Ladner et al. (1996) [23]	Rwanda	To identify factors associated with failure to return for HIV posttest; To assess the prevalence and predictors of counseling in pregnant women in Kigali	Pregnant women	Approximately 2 weeks later	765	Longitudinal/cohort	Among 68.8% returned for their results	Positive HIV test result
Lazebnik et al. (2001) [24]	USA	To quantify the proportion of adolescents who return for their test results and posttest counseling in a free clinic setting and to identify the characteristics predicting their return	Adolescents	Within 10 days	285	Retrospective cohort	42% (overall) returned for their results	Having unprotected sex while using drugs or alcohol; Coming to clinic only for HIV testing; Having private health insurance
Machekano et al. (2000) [25]	Zimbabwe	To describe the correlates of HIV test results-seeking behavior and the use of partner counseling testing services among study participants	Male factory workers	After 2 weeks	3,383	Longitudinal/cohort	56% returned for results	Reporting an STD; Lower monthly salary
Mmbaga et al. (2009) [26]	Tanzania	To assess the prevalence and predictors of failure to return for HIV posttest counseling among adults	General population	2 weeks after blood sample collection	890 (women) 601 (men) Total = 1,491	Cross-sectional	50.9% failed to return for results	Lack of formal education or no education; Lack of HIV/AIDS transmission knowledge; Lack of knowledge of antiretroviral therapy availability; Perceived low risk of HIV infection; Men who were not ready to share their HIV results with their partners; Individuals who reported recent (past month) involvement in multiple sexual partners; Failure to use condom during last casual sex among men; HIV seropositive individuals
Molitor et al. (1999) [27]	USA	To determine the primary predictors of FTR for each of eight types of publicly funded sites in California Predictors of FTR were examined from among those variables assessed during the pretest, risk assessment session.	General population	2 weeks later	370,220	Retrospective cross-sectional	The FTR rate for the entire sample was 16.4%	The type of site at which testing took place (mobile testing,); Race/ethnicity (african american); Risk behavior (IUD); Having sex for money or drugs; Blood transfusion; Sex partner at risk; Multiple sex partners; History of FTR; Age (<20)
Msuya et al. (2006) [28]	Tanzania	To determine the predictors of failure to return (FTR) for HIV posttest results among pregnant women	Pregnant women	After 1 week	2,413	Longitudinal/cohort	7% failed to return	Failure to bring the partner; Site of recruitment; Occasional alcohol consumption; Age of 25 to 29 years; Gestation age of 29 weeks or longer; Alcohol intake by male partner; Male who frequently travel; Never having discussed reproductive health issues with their partners
Sahlu et al. (1999) [29]	Ethiopia	To describe sexual behaviours, perception of risk of HIV infection, and factors associated with attending HIV posttest counseling (PTC) among Ethiopian adults	Factory workers	30 days later at the project’s clinic	407 (male) 344 (female); Total = 751	Longitudinal/cohort	43.5% returned for the test results	Positive association with: Being a manual worker; History of recent casual sexual relationships; Good knowledge of HIV infection; Belief that medical follow-up improves the course of HIV infection; History of genital symptoms; Positive syphilis serology; Recent weight loss; Negative association with: Belief that HIV/AIDS can be cured; Never having been married; Having five or less children; Having been raped; Having used health facilities in the past year
Sesay and Chien (2012) [30]	Gambia	To describe the proportion of clients failing to return for an HIV-test result and to examine the factors associated with failure to return (FTR)	General population	Following day after testing	1,755	Retrospective cross-sectional	30% (overall) failed to return	Male gender; Age under 18; Senegalese and persons of others nationality; Participants with primary and secondary school education; Having ever used condoms; Those who resided in a urban area
Sorin et al. (1996) [31]	USA	Analyses predictors of women’s decisions to accept testing voluntarily and return for their test results	Pregnant women	Not mentioned	6,104	Retrospective cross-sectional	50% of those tested returned for posttest counseling	Minorities (Blacks, Hispanics); Self-paying clients/uninsured; Women receiving less than five prenatal care visits during their pregnancies; Receiving a positive test result
Melo et al. (2012) [32]	Brazil	To examine characteristics associated with rates of psychiatric patients receiving their serologic test results for HIV and other sexually transmitted infections	Psychiatric patients	After a maximum of 4 attempts	2,080	Cross-sectional	79.6% (overall) returned for the results	Living in the same city where the treatment centers were located; Being single; Not having heard of AIDS; Not having been previously HIV tested; Regular free distribution of condoms to patients
Stein and Nyamathi (2000) [33]	USA	To assess gender differences in psychosocial and behavioural predictors of HIV testing and returning for results in a high-risk sample	Heterosexual persons at high risk for HIV	Not mentioned	428 (male) 621 (female) Total = 1,049	Cross-sectional	Men: 17% and women: 15% failed to return	Injection drug use; Self-esteem; Social support; AIDS knowledge; Poor access; Perceived risk; Sexual risk; Negative coping; Positive coping; History of HIV test and return for test results
Sullivan et al. (2004) [34]	USA	To document the frequency of self-reported failure to return for HIV test results (FTR) and associated reasons among persons at high risk for HIV infection	MSM, IDUs, high risk heterosexuals (HRHs)	Not mentioned	782 (MSM) 697 (HRHs) 762 (IDUs) Total = 2,241	Cross-sectional	Overall: 18.4% failed to return	Among HRHs: Higher educational attainment (<high school); Full time employment (<35 hours)
Tao et al. (1999) [35]	USA	To determine the frequency and predictors of receipt of HIV test results for all tested persons in 1994 and 1995 in US publicly funded counseling and testing programs	General population	Not mentioned	19,127 (1994) 16,848 (1995) Total = 35,975	Cross-sectional	In 1994, 12.5%(±1.0%) and 13.3% (±0.9%) in 1995 had not received their test result	People whose test was compulsory; People for whom test was required for hospitalization or surgery; Black people recommended by doctor; Health department; Sex partner; Other reasons
Valdiserri et al. (1993) [36]	USA	To identify factors independently associated with returning for HIV result disclosure and posttest counseling services	General population	Not mentioned	557,967	Retrospective cross-sectional	On average, 63% of persons who received HIV pretest counseling and testing returned to learn their test results and obtain posttest counseling	STD clinic; Family planning clinic; Tuberculosis clinic; Private Physician; College education; Race or ethnicity (Black); Age 13–19; Age 50 or older; Age 40–49; MSM; MSM and IDU; HIV positive; Sex partner at risk; Blood recipient
Van De Ven et al. (2000) [37]	Australia	To know the extent of HIV testing overall and the factors associated with not having HIV test results	MSM	Not mentioned	5,299	Cross-sectional	Overall, 13.3% of the men did not have HIV test results	Younger age; City of residence (Melbourne and Perth); Occupation (clerical/sales and plant operator/labourer); Bisexual/heterosexual; Fewer gay friends; Fewer male sexual partners; Sex with regular and casual partners (having anal intercourse per se with such partners)
Wiley et al. (1998) [38]	USA	To determine the characteristics associated with not receiving an HIV test result in an STD clinic setting	General population	7 to 10 days later	6,988	Cross-sectional	49% did not receive their results	Requesting an HIV test; No tested previously for HIV infection; Blacks Hispanic/Latino; Others
Xu et al. (2011) [9]	China	To analyse the risk factors associated with previous HIV-testing and current posttest follow-up among FSWs in Kaiyuan and Gejii, Yunnan, China	Female sex workers	4 weeks	1,621	Longitudinal/cohort	Overall: 53.3% failed to return	≥9 years of school; <5 clients in the recent week; Were from another province; Were from another city
Ziek et al. (2000) [39]	USA	To examine demographic and behavioral factors related to taking an HIV test and returning for results in a sample of out-of-treatment IDUs and crack smokers	IDUs and crack smokers	3 weeks	927	Longitudinal/cohort	81% return to receive test results	Age per decade; High school graduated; Ever exchanged sex for money; Ever in prison
Cartoux et al. (1998) [40]	Ivory Coast and Burkina Faso	To evaluate the attitude of pregnant women towards HIV testing in two cities of West Africa: Abidjan, Côte d’Ivoire, and Bobo-Dioulasso, Burkina Faso	Pregnant women	2 or 3 weeks	9,724	Longitudinal/cohort	41.6 % in Abidjan and 18.25% in Bobo-Dioulasso, failed to return	Counselor’s attitude; Weeks of gestation; Muslim; Positive HIV infection status; Being merchant profession; Being employee (other); Being 3–6 years in couple; Living in Bobo-Dioulasso; Having knowledge of AIDS; Not using condom for prevention
Pahlavan et al. (2015) [11]	France	To assess the proportion of FTR for an HIV-positive test result among those who tested positive and to identify risk factors associated with FTR	HIV-positive patients	Patient who did follow up for 1 year	509	Retrospective cross-sectional	FTR rate was 14.5%	Heterosexual orientation
Chan et al. (2007) [41]	Australia	To examine the proportion and characteristics of patients who returned to a large sexual health service to obtain their HIV test results	Populations at high risk of STIs and HIV	Within one month	8,715	Cross-sectional study	Overall 79.7% returned within one month of HIV testing,	For male gender; Being an HIV contact MSM; Having more than five sex partners or overseas sex partners in the past 12 months being overseas born
Healey et al. (2010) [20]	Australia	To assess the proportion of patients who returned for HIV results and factors predicting return	General population	Within four weeks	Files of 218 patients	Cross-sectional study (a retrospective review of patients’ files)	45% returned for their results	Male gender; Attending the men-only outreach clinic; Having the first HIV test at the clinic; Having sex with overseas-born individual in the past year