Strategies for implementing HIV self-testing in diverse populations: an integrative review

Area of Science:

• Public Health
• Epidemiology
• HIV Prevention

Background:

• HIV self-testing offers a discreet and accessible method for HIV status determination.
• Implementing effective HIV self-testing distribution strategies is crucial for expanding access and improving outcomes.

Purpose of the Study:

• To identify and evaluate strategies for the successful implementation of HIV self-testing in diverse populations.
• To understand the facilitators and barriers associated with HIV self-testing distribution.

Main Methods:

• An integrative review of five major databases (MEDLINE/PubMed, Scopus, CINAHL, Web of Science, LILACS).
• Inclusion of 24 full-text articles in Portuguese, English, Spanish, or French, regardless of publication year.
• Exclusion of non-eligible studies like review articles and professional-administered tests.

Main Results:

• Community-based distribution (home visits, mail, public venues) was the most prevalent strategy.
• Peer distribution proved effective for key populations, including men who have sex with men, young people, and transgender women.
• Social and digital media supported recruitment, delivery, and linkage to care.

Conclusions:

• Community distribution of HIV self-tests enhances uptake of combination HIV prevention and antiretroviral therapy initiation.
• Significant implementation challenges include financial costs, fear of results, stigma, and intimate partner violence.
• Accessible distribution models are vital for maximizing the impact of HIV self-testing programs.