A principle-based approach to justify the use of HIV self-testing in South Africa

The South African government introduced the use of an HIV self-testing (HIVST) kit in 2016 to expand access to HIV testing services and to increase HIV testing uptake among men and key populations who may otherwise not test. By reviewing existing empirical data, including existing guidelines regarding the implementation and use of HIV self-testing, this research explores the ethical implications of using the HIV self-testing kit and draws arguments from the ethical principles: respect for autonomy, beneficence, non-maleficence, and social justice. The implementation of HIV self-testing in South Africa does not violate any ethical principles; however, the potential occurrences of coercion and intimate partner violence surrounding HIV self-testing remain issues of concern challenging the principle of non-maleficence. Furthermore, the available empirical data on potential harm does not provide compelling ethical grounds for restricting the sale of HIVST kits in South Africa. Hence, HIVST in South Africa remains an ethically justified intervention.