HIV self-testing in Africa: stakes and challenges

Area of Science:

• Public Health
• Infectious Diseases
• Global Health

Background:

• HIV self-testing offers a novel approach to complement existing HIV testing strategies.
• It targets both general and key populations, including sex workers, men who have sex with men, and young people.
• Pilot studies in Africa, primarily in English-speaking regions, show high acceptability, practicability, and clinical performance.

Purpose of the Study:

• To evaluate the role of HIV self-testing in achieving UNAIDS 90-90-90 targets.
• To explore strategies for implementing HIV self-testing in sub-Saharan Africa.
• To assess the need for culturally adapted testing materials.

Main Methods:

• Review of pilot studies on HIV self-testing acceptability, practicability, and performance.
• Analysis of strategies for reaching key populations with HIV self-testing.
• Consideration of innovative approaches for diverse linguistic and cultural contexts.

Main Results:

• HIV self-testing demonstrates high acceptability and practicability in African pilot studies.
• Clinical performance of HIV self-testing is reliable.
• Existing studies are concentrated in English-speaking African countries.

Conclusions:

• HIV self-testing is a viable strategy to enhance HIV testing coverage and progress towards UNAIDS goals.
• Innovative implementation strategies, including vernacular language instructions and pictograms, are needed for sub-Saharan Africa.
• Further research and evaluation are required to optimize HIV self-testing in diverse African settings.