Purpose of Review
We describe the evidence regarding the impact of offering HIV self-testing (HIVST) and explore the gaps that need to be filled to design and implement HIVST programs.
Numerous randomized controlled trials found that offering HIVST increases HIV testing rates. However, these trials used an oral HIVST that was provided for free and there is no research examining the impact of offering blood-based (finger prick) kits or charging for HIVST kits. The trials also used various methods for distributing the HIVST kits, but there is little research comparing distribution methods. Study participants varied in the HIV testing method they chose when given choices, suggesting that offering multiple HIV testing options may be needed to maximize testing rates.
Despite the consistent finding that offering HIVST increases HIV testing rates, questions remain that need to be answered in order to maximize the potential of this new biomedical technology.
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Papers of particular interest, published recently, have been highlighted as: •• Of major importance
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•• Chanda MM, Ortblad KF, Mwale M, Chongo S, Kanchele C, Kamungoma N, et al. HIV self-testing among female sex workers in Zambia: a cluster randomized controlled trial. PLoS Med. 2017;14(11):e1002442. https://doi.org/10.1371/journal.pmed.1002442One of only two studies that compred HIVST kit distribution methods (Direct provision by peer educators versys indirect provision whereby peer educators give coupons redeemable at clinics for HIVST kits).
•• Ortblad K, Kibuuka Musoke D, Ngabirano T, Nakitende A, Magoola J, Kayiira P, et al. Direct provision versus facility collection of HIV self-tests among female sex workers in Uganda: a cluster-randomized controlled health systems trial. PLoS Med. 2017;14(11):e1002458. https://doi.org/10.1371/journal.pmed.1002458One of only two studies that compred HIVST kit distribution methods (Direct provision by peer educators versys indirect provision whereby peer educators give coupons redeemable at clinics for HIVST kits).
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Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
The work presented in this article did not involve human or animal subjects.
Elizabeth A. Kelvin is supported by Einstein-Rockefeller-CUNY Center for AIDS Research [P30-AI124414] which is supported by the following National Institutes of Health (NIH) Co-Funding and Participating Institutes and Centers: NIAID, NCI, NICHD, NHBL, NIDA, NIMH, NIA, FIC, and OAR. Ms. Akasreku is supported by a CUNY Graduate School of Public Health and Health Policy Dean’s Fellowship award.
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Kelvin, E.A., Akasreku, B. The Evidence for HIV Self-Testing to Increase HIV Testing Rates and the Implementation Challenges that Remain. Curr HIV/AIDS Rep 17, 281–289 (2020). https://doi.org/10.1007/s11904-020-00504-3
- HIV self-testing
- Implementation science