Objective To analyze the repetitive HIV tests under different HIV testing strategies in Sichuan province and provide evidence for the optimization of HIV testing service.

Methods In this study, the HIV-antibody testing records of Sichuan province in 2024 were collected from the Sichuan health records cloud platform. SPSS 26 software was used for data cleaning and statistical analysis, and statistical description of the general and distribution situation of repeated tests for HIV antibodies was conducted. χ² were performed of the repeated HIV-antibody testing rates by different testing strategies and by different sample sources, with pairwise comparisons adjusted using the Bonferroni method; The median and quartile of repeat testing interval for different HIV-antibody testing strategies were calculated, and the Kruskal Wallis rank sum test was used to compare the differences in repeat testing interval.

Results In 2024, a total of 33 395 867 people in Sichuan Province underwent HIV-antibody testing, with a coverage rate of 39.91% for the entire population. Among them, 10 449 020 individuals had undergone two or more HIV-antibody tests. The average times of tests was 2.73, The median interval between repeated tests was 43 days, and the interquartiles were 14 days and 110 days. The total number of HIV-antibody tests conducted in Sichuan Province in 2024 reached 51 517 888 times, the repeat HIV-antibody testing rate was 35.18%, the repeat testing rate of male was 33.29% lower than that of female (36.75%), and the repeat testing rate of individuals below 50 years old was 31.08% lower than aged 50 and older 38.04%. In this study, the HIV testing strategies were divided into six categories. The repeat testing rates of different HIV testing strategies from high to low were: policy-mandatory testing（88.06%）, PITC related to clinical diagnosis and treatment（42.11 %）, voluntary counseling and testing（31.43%）, community-based and social network mobilization testing（30.05%）, population-specific screening（25.33%）, and public health services-related PITC（23.94%）; The median interval between repeated tests was the smallest for policy-mandated testing (14 days), followed by for special screening of the entire population (27 days). The sample source with the highest repetitive testing rate in PITC was pregnancy examination 52.88%. The second was testing before blood transfusion 48.46%, and testing by other clinical patients 41.72%.

Conclusion The repeated testing rate in Sichuan Province reflects the varying efficiency of HIV-antibody testing services in covering untested populations as the testing volume increases among different testing strategies. The repetitive testing rate of HIV antibodies in Sichuan Province also reveals that the phenomenon of individual repetitive testing in HIV-antibody testing services is common, suggests the direction of attention and optimization in terms of repeated testing.It is necessary to further explore the different screening frequencies of HIV antibodies based on different populations and testing sources.