HIV Self-Testing Uptake and Intervention Strategies Among Men in Sub-Saharan Africa: A Systematic Review

Hamilton, Akeen; Thompson, Noah; Choko, Augustine; Hlongwa, Mbuzeleni; Jolly, Pauline E.; Korte, Jeffrey E.; Conserve, Donaldson F.

doi:10.3389/fpubh.2021.594298

Cited by 59 publications

(58 citation statements)

References 78 publications

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“…2 Concerns raised regarding HIVST include lack of HIV counselling, 30 instructions are difficult to follow 31 and there should be more of a focus on linkage to care. 32 This research study has a few limitations. 'Ever testing' for HIV is self-reported, and therefore, prone to biases related to social desirability, recall and under-reporting.…”

Section: Discussionmentioning

confidence: 93%

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Geographical variation in HIV testing in South Africa: Evidence from the 2017 national household HIV survey

Jooste

Mabaso

Taylor

et al. 2021

Southern African Journal of HIV Medicine

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Background: Identification of the geographical areas with low uptake of HIV testing could assist in spatial targeting of interventions to improve the uptake of HIV testing.Objectives: The objective of this research study was to map the uptake of HIV testing at the district level in South Africa.Method: The secondary analysis used data from the Human Sciences Research Council’s 2017 National HIV Prevalence, Incidence, Behaviour and Communication Survey, where data were collected using a multistage stratified random cluster sampling approach. Descriptive spatial methods were used to assess disparities in the proportion of those ever tested for HIV at the district level in South Africa.Results: The districts with the highest overall coverage of people ever having tested for HIV ( 85%) include West Rand in Gauteng, Lejweleputswa and Thabo Mofutsanyane in Free State, and Ngaka Modiri Molema in North-West. These provinces also had the least variation in HIV testing coverage between their districts. Districts in KwaZulu-Natal had the widest variation in coverage of HIV testing. The districts with the lowest uptake of HIV testing were uMkhanyakude (54.7%) and Ugu (61.4%) in KwaZulu-Natal and Vhembe (61.0%) in Limpopo. Most districts had a higher uptake of HIV testing amongst female than male participants.Conclusion: The uptake of HIV testing across various districts in South Africa seems to be unequal. Intervention programmes must improve the overall uptake of HIV testing, especially in uMkhanyakude and Ugu in KwaZulu-Natal and Vhembe in Limpopo. Interventions must also focus on enhancing uptake of HIV testing amongst male participants in most districts. Strategies that would improve the uptake of HIV testing include HIV self-testing and community HIV testing, specifically home-based testing.

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Section: Discussionmentioning

confidence: 93%

“…2 Concerns raised regarding HIVST include lack of HIV counselling, 30 instructions are difficult to follow 31 and there should be more of a focus on linkage to care. 32 …”

Section: Discussionmentioning

confidence: 99%

Geographical variation in HIV testing in South Africa: Evidence from the 2017 national household HIV survey

Jooste

Mabaso

Taylor

et al. 2021

Southern African Journal of HIV Medicine

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“…Despite extraordinary progress in HIV treatment coverage and in expanding access to HIV prevention services, the epidemics of West, Central, East and Southern Africa continue in 2020, with incidence rates too high to achieve epidemic control in many countries and populations [1]. Across Africa, prevalence burdens and incidence rates remain highest among “key populations” including women and men who sell or trade sex, men who have sex with men (MSM), people who inject drugs (PWID), transgender women who have sex with men and prisoners and detainees [1‐10]. These groups, often clustered together as key populations, account for the large majority of new infections in West, North and Central Africa, and an estimated 25% of new infections in East and Southern Africa, despite representing relatively small proportions of those overall populations [1].…”

Section: Introductionmentioning

confidence: 99%

Overview of the epidemiological conditions of HIV among key populations in Africa

Jin¹,

Restar²,

Beyrer³

2021

J Int AIDS Soc

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Introduction Despite extraordinary progress in HIV treatment coverage and expanding access to HIV prevention services and that multiple African countries are on track in their efforts to reach 90‐90‐90 goals, the epidemic continues to persist, with prevalence and incidence rates too high in some parts of the continent to achieve epidemic control. While data sources are improving, and research studies on key populations in specific contexts have improved, work on understanding the HIV burdens and barriers to services for these populations remains sparse, uneven and absent altogether in multiple settings. More data have become available in the last several years, and data published in 2010 or more recently are reviewed here for each key population. This scoping review assesses the current epidemiology of HIV among key populations in Africa and the social and political environments that contribute to the epidemic, both of which suggest that without significant policy reform, these epidemics will likely continue. Results and discussion Across Africa, the HIV epidemic is most severe among key populations including women and men who sell or trade sex, men who have sex with men, people who inject drugs, transgender women who have sex with men and prisoners and detainees. These groups account for the majority of new infections in West and Central Africa, and an estimated 25% of new infections in East and Southern Africa, despite representing relatively small proportions of those populations. The HIV literature in Africa emphasizes that despite significant health needs, key populations experience barriers to accessing services within the healthcare and legal justice systems. Current shortcomings of surveillance systems in enumerating key populations impact the way funding mechanisms and resources are allocated and distributed. Adapting more equitable and epidemiologically sound frameworks will be necessary for current and future HIV programming investments. Conclusions Through this review, the available literature on HIV epidemiology among key populations in Africa brings to light a number of surveillance, programmatic and research gaps. For many communities, interventions targeting the health and security conditions continue to be minimal. Compelling evidence suggests that sweeping policy and programmatic changes are needed to effectively tackle the persistent HIV epidemic in Africa.

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“…HIV self-testing has increased HIV testing uptake, particularly in East Africa [ 24 , 31 – 33 ]. HIV self-testing offers the opportunity to test sexual partners, and it promotes earlier treatment initiation [ 16 , 19 , 34 ]. Compared with conventional facility-based HIV testing, HIV self-testing yields benefits in terms of maintaining privacy, saving time and resources, informing sexual health decision-making, and reducing the anxiety experienced when waiting for results in a conventional HIV testing scenario [ 21 , 29 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Values and preferences for hepatitis C self-testing among the general population and healthcare workers in Rwanda

et al. 2021

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Background In 2018, Rwanda launched a 5-year hepatitis C virus (HCV) elimination plan as per the World Health Organization global targets to eliminate HCV by 2030. To improve awareness of HCV status, strategies are needed to ensure easy access to HCV testing by as-yet unreached populations. HCV-self-testing, an innovative strategy, could further increase HCV testing uptake. This assessment explores perceptions around HCV self-testing among members of the public and healthcare workers in Rwanda. Methods A qualitative study was undertaken in Masaka District Hospital, comprising individual interviews, group interviews and participatory action research (PAR) activities. Purposive and snowball sampling methods guided the selection of informants. Informed consent was obtained from all participants. A thematic analysis approach was used to analyse the findings. Results The participants comprised 36 members of the public and 36 healthcare workers. Informants appreciated HCV self-testing as an innovative means of increasing access to HCV testing, as well as an opportunity to test privately and subsequently autonomously decide whether to seek further HCV care. Informants further highlighted the need to make HCV self-testing services free of charge at the nearest health facility. Disadvantages identified included the lack of pre/post-test counselling, as well as the potential psychosocial harm which may result from the use of HCV self-testing. Conclusion HCV self-testing is perceived to be an acceptable method to increase HCV testing in Rwanda. Further research is needed to assess the impact of HCV self-testing on HCV cascade of care outcomes.

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HIV Self-Testing Uptake and Intervention Strategies Among Men in Sub-Saharan Africa: A Systematic Review

Cited by 59 publications

References 78 publications

Geographical variation in HIV testing in South Africa: Evidence from the 2017 national household HIV survey

Geographical variation in HIV testing in South Africa: Evidence from the 2017 national household HIV survey

Overview of the epidemiological conditions of HIV among key populations in Africa

Values and preferences for hepatitis C self-testing among the general population and healthcare workers in Rwanda

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