HIV self-testing strategy: the middle road

New HIV testing technologies in the context of a concentrated epidemic and evolving HIV prevention: qualitative research on HIV self‐testing among men who have sex with men and transgender women in Yangon, Myanmar

“…Salivary-based rapid HIV tests generally have sensitivity of 91.7% and specificity of 97.9% and have been approved by the United States (U.S.) Food and Drug Administration (FDA) for home use due to their potential to reduce undiagnosed HIV infections [11]. Rapid HIV tests allow individuals to conduct rapid screening tests easily and privately at the location of their choosing, obtain preliminary HIV test results in settings that are free from potential stigma and discrimination, support individual self-efficacy to care for their health, and reduce travel and waiting times associated with facility-based testing [10,[12][13][14][15][16][17]. In contexts where sexual behaviours or HIV status may be stigmatized, self-testing provides a promising alternative to provider-implemented testing programs.…”

Perspective on HIV Self-testing in North America: A Tale of Two Countries—US and Canada

“…4,20 Therefore, discrepancy in these estimates merit a scrutiny for future improvement. 21,22 Overall, an offer of privacy, time savings, convenience, and successful initiation of linkages to treat individuals who tested positive in preliminary self-test facilitated a high acceptability and preference for both self-testing strategies.…”

“…20 But before this strategy can be hailed as a game changer, multiple obstacles stand in its way and a clear concerted plan of action has not yet been realized for any country. Multiple challenges stand in the way of implementation of both unsupervised and supervised strategies, which include the following: (a) public-private partnerships for a seamless connected system of care; (b) engagement of trained counselors; (c) setting up supervised self-testing kiosks in emergency rooms, outreach settings, mobile vans, community clinics, and HIV clinics; (d) payment systems for screening and linkages for both unsupervised and supervised strategies if offered privately; (e) creative payment solutions for mobile phone-based and internet-based counseling that can reach many more populations Canada-wide; (f) effective communications between different stakeholders involved in the testing and counseling process; and, lastly, (g) expedited confirmatory tests available through public and private channels.…”

Perceived Cost Advantages and Disadvantages of Purchasing HIV Self-Testing Kits among Urban Tanzanian Men: An Inductive Content Analysis

“…HIVST is defined as any mode of HIV testing that allows a person to collect his own specimen in private, conduct a rapid antibody test, and be the first person to learn of the results [10,24]. HIVST differs from mobile-and homebased HCTS in that it is not conducted by a trained health care provider [25,26]. The oral fluid HIV self-testing kit has increasingly been piloted in sub-Saharan Africa and found to be feasible and acceptable in countries such as South Africa [25,27], Malawi [23,28,29], Kenya [30,31] and Uganda [32].…”

“…The World Health Organization also released guidelines in 2016 to support the implementation and scale-up of HIVST [35]. Proposed advantages of HIVST are that it has the potential to reach untested individuals, including those who infrequently engage with the health care system -and thereby drastically reduce the number of undiagnosed HIV cases [8,10,26,36,37]. Proponents of HIVST also note that it is convenient, addresses stigma, privacy and confidentiality barriers to facility-based testing, can be provided at scale and at relatively low cost, and empowers individuals to make positive health decisions [10,25,26,36].…”