Uptake of HIV Retesting Among Black Populations in Miami-Dade: Implications for Community-Based Prevention

The Southern United States bears nearly half of all new HIV diagnoses, with Miami-Dade County experiencing one of the highest incidence rates nationwide. Black communities in Miami face disproportionate HIV-related outcomes, yet little is known about repeat HIV testing within these populations. This study examined engagement in HIV retesting through the Community-Based HIV Awareness for Minority Populations (CHAMP) program, a community health worker-led, street-based HIV testing and linkage-to-care initiative serving historically Black communities in Miami-Dade County. From December 2016 to February 2020, participants received rapid HIV testing and completed surveys assessing demographic characteristics and behavioral risk factors. Univariable analyses and latent class analysis were used to examine factors associated with CHW-facilitated retesting, defined as completing more than one HIV test through CHAMP. Among 1825 participants, 51% were female, 91% identified as Black, and the median age was 38 years. Approximately half reported at least one HIV-related risk behavior. Although 77% had previously tested for HIV, only 6% (n = 98) completed repeat testing through CHAMP. Retesting differed significantly by ethnicity and nativity but was not associated with latent class membership. Despite substantial baseline HIV risk, repeat testing within this CHW-led program remained low, with meaningful variation across cultural subgroups. Culturally tailored strategies that emphasize the importance of routine retesting may strengthen sustained engagement in HIV prevention services among high-priority populations.