New initiatives to develop self-testing for HIV

Abstract

The purpose of this review is to describe the most recent literature on outcomes and issues associated with HIV self-testing (HIVST). HIVST is acceptable to a range of populations in a variety of contexts, particularly if users' values and preferences are taken into account in intervention development. Approaches being explored in ongoing and planned studies are the efficacy of HIVST to increase diagnosis of long-standing prevalent infections and to reduce the interval between HIV transmission and diagnosis, particularly in high-incidence groups. Though there is little evidence of harms related to HIVST, this remains a potential issue. Concerns remain about the reliability of currently available HIVST kits, which have lower sensitivity than testing options available in clinical settings, particularly in early HIV infection. Evidence on linkage to care for confirmatory testing after a reactive HIVST result and the cost-effectiveness of HIVST to increase rates of HIV diagnosis is currently limited. HIVST is a relatively new innovation that is acceptable to key populations and which could increase HIV testing rates and rates of HIV diagnosis, especially in at-risk groups. Concerns remain about test sensitivity (particularly in early infection), and linkages to care for confirmatory testing after a reactive HIVST.