HIV self-testing: a great step towards fighting new infections

Recently, the Deputy Minister for Health during the parliamentary question and answer session indicated of current plans to pilot HIV self-testing in the near future. I must say this is a great step and deserves to be commended.

A year ago the World Health Organisation released a new guideline on HIV self-testing with intentions of improving access and uptake of HIV diagnosis.

HIV self-testing is when a person is interested to know his/her HIV status and would prefer doing a test privately. This would mean to collect specimen which will be used for testing, performing the test and interpreting results himself or herself.

This can be done anywhere in a private place such as your own bedroom.

We all know the current practice is to visit a facility where HIV testing is offered, one receives counselling and receives the HIV status results after getting tested. This would mean tests being done in the laboratory by experienced laboratory technicians.

So how reliable will self-testing be?

Rapid diagnostic HIV test kits for HIV self-testing have been developed tested and validated in different settings.

This means they can be used with high degree of reliability as screening tools. These test kits test for the presence of antibodies against HIV virus.

Briefly, when an individual is infected with HIV, the body defense mechanism will react by trying to fight the engaging immune defense mechanisms including release antibodies which are specific for HIV virus. These antibodies are expected to be present in the body if an individual is infected and the body has had enough time to mount the immune reaction.

Antibodies take 6-12 weeks to develop. So a positive test would mean presence of antibodies hence HIV positive and a negative would mean absence.

Self-testing kits use either blood which is commonly used even at facilities or oral fluids from the mouth.

It is important to mention that, a positive self-testing result must be confirmed at the health facility.

In many studies done in different parts of the world including Africa, HIV self-testing has been shown to be acceptable in the general population with acceptability ranging from 74 percent to as high as 96 per cent.

Advantages of such new interventions

HIV self-testing is expected to increase the number of people knowing their HIV status.

Although there has been a great achievement in terms of HIV testing, for example the proportion of people learning their HIV status increased from 12 to 60 per cent between 2005 and 2015, the ambitious global target of reaching 90 per cent will require new interventions such as HIV self-testing.

With self-testing it is expected stigma will decrease as testing comes closer to the population in addition to early treatment initiation benefits which comes with knowing ones status.

The planned pilot, among others should enlighten on the following;

• Firstly, on how will self-testing kits be distributed or accessed in the community as well as on control of manufacturer’s requirements on storage, temperature and shipment.

• Secondly, on what’s the best minimum essential information that is required for an individual to be aware before doing HIV self-testing.

• Thirdly, on the data on how many have self-tested and their results as well as how such information can be accurately collected and used for future decision making.

Indeed upon scale up, HIV-self testing is expected to increase HIV diagnosis and more importantly early diagnosis, which provide a window for early initiation of treatment and eventually control new infections.

HIV self-testing will remain an important step towards fighting HIV.