Making HIV self-testing a reality
I wish I could say to you that I am reporting from the Aids 2014 conference in Melbourne, Australia. That I have learnt new insights about prevention, care and cure; interacted with change makers in HIV research and advocacy…but alas I cannot, my attempts to get funding to attend the conference both through a media scholarship and through work sadly did not get favourable responses. I am sure Malawian researchers, community workers, activists and media were there in droves and have been and shall continue to update us on the latest from Aids 2014.
Reading through a number of blogs and news reports from the conference, one particular caught my eye onaidsmap.com on what needs to be done to make HIV self-testing a reality? Studies have been conducted in Malawi on self testing that showed self testing is feasible and accepted in communities. Self-testing has a huge potential to reduce undiagnosed infection but in order for it to be a reality, a number of factors need to be considered: Methods of distribution, linking testing to care, tests that are easy to administer, and according to theaidsmap article review of national policies to encourage commercial manufacture of such tests.
Self-testing is attractive because of its convenience, privacy, confidentiality with instant results. Although a number of studies suggest that self testing is attractive, the World Health Organisation and UNAIDS, the major organisations that develop guidelines for HIV and Aids, have not come out publicly to recommend self-testing, cautiously suggesting more evidence is needed before they can advise countries on changing policy.
The barriers to self-testing, is fear of mandatory or coercive testing by employers or partners, incorrect use, poor linkage to care for those who test positive. WHO has, however, began to consider self-testing scenarios such as sales through pharmacies, websites, vending machines as well as possibility of supervised self-testing through public health facilities.
A study to check correct usage filmed people using the self-test kits and found errors were common. Users either did not perform all steps, made multiple mistakes, complained about unclear instructions like use of the word ‘swab’. However, despite these problems most people rated the tests as easy to use and were quite excited about the potential for self-testing. The biggest challenge is linking users to care.
