HIV Self-Testing Proven to be Safe and Effective

Self-testing may help control global spread of HIV/AIDS.

HIV self-testing (HIVST) was proven to be effective in a recent study conducted in Malawi. The process was proven to be widely used, safe, accurate, and acceptable in urban settings of sub-Saharan Africa.

In sub-Saharan Africa, only 25% of adults have had a recent test and only 50% of people with HIV know they are infected. While home-based HIV testing and counseling (HTC) can achieve increased uptake of testing, it requires heavy involvement of trained health care workers.

The alternative to HTC is HIVST. In a 2-year community-based prospective study in Malawi, 75% of residents in the study self-tested, with the highest uptake seen in women and adolescents, but also unusually high participation among men. More than half of the 1257 participants who discovered they were HIV-positive accessed HIV care.

Of the 1257 participants, 94.6% reported being highly satisfied with HIVST, even though a low percentage reported feeling forced into testing, most likely by their sexual partner. Importantly, no HIVST-related partner violence or suicides occurred.

The authors acknowledge the limitations of the study design that may have introduced some imprecision around the estimates of uptake and linkage into care, and also that the acceptability and accuracy of HIVST may differ between urban and rural communities. However, the results suggest that HIVST may be a viable option for these communities to control their HIV/AIDS epidemic.

The authors conclude, “Continued high uptake in the second year suggests that scaling up HIVST could have a sustained impact on the coverage of HIV testing and care in Africa, especially for men and adolescents.”