What proportion of persons newly diagnosed with HIV is expected to be recent?

The expected proportion will vary by country based on local epidemic factors such as HIV incidence and program context such as testing strategy, frequency, and coverage among those at- risk. The observed range based on RITA (RTRI and additional VL testing among those RTRI-recent) classification from October 2020-September 2021 was from 3% to 19% across PEPFAR countries. This proportion may also be affected by the fraction of individuals testing HIV-positive who are re- testers and may not be “newly diagnosed”. Current data from countries implementing routine recent infection surveillance, suggest that 30%-50% of HTS clients may be re-testers. People who re-test (and go unrecognized at time of testing) can increase the denominator of the recent infection calculation and reduce the proportion classified as recent. Appropriate pre-test counseling, and if available, unique ID and case surveillance systems can help recognize people who are retesting and should not be tested with RTRI and thereby improve accuracy of recent infection surveillance. VL testing as a part of RITA is also strongly recommended to better recognize and reclassify re-testers.