Abstract
HIV Self-Testing (HIVST) aims to increase HIV testing coverage and can facilitate reaching the UNAIDS 90-90-90 targets. In Senegal, key populations bear a disproportionate burden of HIV and report limited uptake of HIV testing given pervasive stigma and criminalization. In these contexts, HIVST may represent a complementary approach to reach populations reporting barriers to engagement with existing and routine HIV testing services. In this study, 1839 HIVST kits were distributed in Senegal, with 1149 individuals participating in a pre-test questionnaire and 817 participating in a post-test questionnaire. Overall, 46.9% (536/1144) were first-time testers and 26.2% (300/1144) had tested within the last year; 94.3% (768/814) reported using the HIVST, and 2.9% (19/651) reported a reactive result which was associated with first-time testers (p = 0.024). HIVST represents an approach that reached first-time testers and those who had not tested recently. Implementation indicators suggest the importance of leveraging existing community structures and programs for distribution.
Highlights
Increasing coverage of HIV testing and early detection of seroconversion among people living with HIV is essential for effectively responding to the HIV pandemic
A total of 1839 HIV self-testing (HIVST) kits were distributed between April 2017 to June 2018, and 62.5% (1149/1839) of recipients participated in the pre-test questionnaire before receiving the HIVST (Table 1)
This study demonstrates that HIVST can effectively engage first-time testers at risk for HIV in Senegal, including key populations, cisgender men, and young adults
Summary
Increasing coverage of HIV testing and early detection of seroconversion among people living with HIV is essential for effectively responding to the HIV pandemic. Detection of HIV and initiation of antiretroviral therapy (ART) significantly reduces HIV-related morbidity and mortality, and can improve the quality of life for people living with HIV while eliminating the risk of onward HIV transmission [1,2,3]. HIV self-testing (HIVST) is emerging as an important tool to potentially increase the uptake and the frequency of HIV testing in populations at increased risk for acquiring HIV such as key populations who may avoid HIV testing services because of stigma and criminalization of their sexual practices, orientation, or occupation, or even the criminalization of HIV transmission [6]. Given the rapid adoption of HIVST globally, WHO guidelines have been developed to support the implementation and scale-up of ethical, effective, acceptable, and evidence-based approaches to HIVST [9]
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