Factors Associated With Recent HIV Infections Among Newly HIV Diagnosed in Rwanda

Rwanda has initiated recency testing alongside existing HIV testing services of provider-initiated testing, partner notification services (PNSs), and of prevention of mother-to-child HIV transmission. We aimed to determine characteristics of the newly diagnosed population using a nationwide cohort.

We included all newly diagnosed patients with HIV aged 15 and above who consented to recency testing and assessed patient- and health center-related predictors of recent HIV infection using multivariable logistic regression models.

We obtained data from 485 of 565 health facilities in Rwanda that introduced PNS and recency testing alongside preexisting testing services. From October 2018 to February 2024, 8940 individuals consented to HIV recency testing. Among them, 537 (6.0%) were recently infected. The odds of detecting a recent HIV infection increased by 1% for each month of experience in PNS. Patient-related factors associated with recent infections included female sex, younger age (15-24 years), residing in southern or northern provinces compared with the western province, and self-reported sex with a known HIV-infected person or unprotected sex outside of a relationship in the last 12 months.

Only 6% of newly diagnosed HIV infections were characterized as recent. Public health interventions targeting younger females may assist in reducing new infections in this group.