South African HIV self-testing policy and guidance considerations

Abstract

The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST) have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO) released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS) and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017–2022. This document serves as an additional guidance for the National HIV Testing Services Policy 2016, with specific focus on HIVST. It is intended for policy advocates, clinical and non-clinical HTS providers, health facility managers and healthcare providers in private and public health facilities, non-governmental, community-based and faith-based organisations involved in HTS and outreach, device manufacturers, workplace programmes and institutes of higher education.

HIV self-screening distribution preferences and experiences among men who have sex with men in Mpumalanga Province: Informing policy for South Africa

“…[6] It is critical that we expand HIV testing options for key populations with approaches that are responsive to their needs. HIV self-screening (HIVSS) has been found to be highly acceptable among MSM, [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] and may be effective in reducing the time to diagnosis and treatment and thus the incidence of new HIV infections. [9] MSM at our research site in Mpumalanga preferred HIVSS to clinic-based testing, with >80% stating a preference for the former.…”

“…The Southern African HIV Clinicians Society developed a document on self-testing policy and guidance considerations. [14] This was followed by the publication of the National Department of Health HIVSS guidelines in May 2018, [22 ] which focus on considerations for effective and safe use of HIVSS. While potential distribution channels are listed (communitybased, facilities-based, secondary distribution to partners), detailed guidance for implementation (when, where and how to distribute tests) is not provided, given the lack of data across target groups needed to guide implementation.…”

Guidelines to support HIV-affected individuals and couples to achieve pregnancy safely: Update 2018

“…Any positive self-screening result must be confirmed according to standard algorithms for facility-based or community-based testing. 77 …”

Acceptability of HIV self-testing is low among MSM who have not tested: a study with respondent-driven sampling in Brazil

“…HIVST is simple, easy to use, allows the individual to carry out the test, can use oral uid or blood sample, and the interpretation of results may be undertaken with or without help from a trained individual [23]. This test procedure should be largely available as complementary to other available options [24].…”