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New initiatives to develop self-testing for HIV

Witzel, T. Charles; Rodger, Alison J.

Current Opinion in Infectious Diseases: February 2017 - Volume 30 - Issue 1 - p 50–57
doi: 10.1097/QCO.0000000000000336
HIV INFECTIONS AND AIDS: Edited by David H. Dockrell

Purpose of review: The purpose of this review is to describe the most recent literature on outcomes and issues associated with HIV self-testing (HIVST).

Recent findings: 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.

Summary: 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.

aSigma Research, Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine

bResearch Department of Infection & Population Health, University College London, London, UK

Correspondence to Alison J. Rodger, Research Department of Infection & Population Health, University College London (UCL), Rowland Hill Street, London NW3 2PF, UK. Tel: +44 20 7472 6754; fax: +44 20 7794 1224; e-mail: alison.rodger@ucl.ac.uk

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