Self-testing as strategy to increase the uptake of HIV testing in South Africa

2013 ◽  
Vol 12 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Alta C van Dyk
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Self Testing

scholarly journals Implementation of different HIV self-testing models with implications for HIV testing services during the COVID-19 pandemic: study protocol for secondary data analysis of the STAR Initiative in South Africa

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e048585
Author(s):  
Mohammed Majam ◽  
Donaldson F Conserve ◽  
Vincent Zishiri ◽  
Zelalem T Haile ◽  
Angela Tembo ◽  
...  
Keyword(s):  
South Africa ◽  
Data Analysis ◽  
Hiv Testing ◽  
Linkage To Care ◽  
Secondary Data ◽  
Factors Associated ◽  
Self Testing ◽  
Hiv Testing Services ◽  
Care And Treatment ◽  
Risk Ratios

IntroductionHIV self-testing (HIVST) presents a convenient, private approach that removes barriers to providing HIV testing services. The Self-Testing Africa (STAR) Initiative aims to scale up HIVST among priority and undertested populations. HIVST has the potential to help maintain testing services during the social distancing restrictions implemented to prevent the spread of COVID-19. This project evaluates linkage to confirmatory testing and treatment for HIV-positive clients for the STAR South Africa site.Methods and analysisThis secondary data analysis protocol aims to evaluate different HIVST distribution models from a prospective study implemented during November 2017 and December 2020 by Ezintsha, a subdivision of Wits Reproductive Health and HIV Institute. Routinely collected distribution and self-reported HIVST outcomes data will be deidentified and analysed. The main outcomes of interest are linkage to care and treatment among HIVST users who report a reactive HIVST result. Additionally, we plan to determine sociodemographic factors associated with linkage to care and treatment among HIVST users. Descriptive statistics will be used to describe the variables of interest, and modified Poisson regression with robust variance estimation will be performed to identify factors associated with linkage to care and treatment among HIVST users who report a reactive HIVST result. Risk ratios and 95% CIs for the risk ratios will be reported.Ethics and disseminationThe study protocol has been approved by the University of Witwatersrand Human Research Ethics Committee. The dissemination plan for the study findings will include presentations to local and international health authorities, international conferences and publications in open access journals.

scholarly journals Costs of integrating HIV self-testing in public health facilities in Malawi, South Africa, Zambia and Zimbabwe

2021 ◽  
Vol 6 (Suppl 4) ◽  
pp. e005191
Author(s):  
Linda Alinafe Sande ◽  
Katleho Matsimela ◽  
Lawrence Mwenge ◽  
Collin Mangenah ◽  
Augustine Talumba Choko ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Hiv Testing ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Time And Motion ◽  
Self Testing ◽  
Secondary Distribution ◽  
Facility Level ◽  
The Cost

IntroductionAs countries approach the UNAIDS 95-95-95 targets, there is a need for innovative and cost-saving HIV testing approaches that can increase testing coverage in hard-to-reach populations. The HIV Self-Testing Africa-Initiative distributed HIV self-test (HIVST) kits using unincentivised HIV testing counsellors across 31 public facilities in Malawi, South Africa, Zambia and Zimbabwe. HIVST was distributed either through secondary (partner’s use) distribution alone or primary (own use) and secondary distribution approaches.MethodsWe evaluated the costs of adding HIVST to existing HIV testing from the providers’ perspective in the 31 public health facilities across the four countries between 2018 and 2019. We combined expenditure analysis and bottom-up costing approaches. We also carried out time-and-motion studies on the counsellors to estimate the human resource costs of introducing and demonstrating how to use HIVST for primary and secondary use.ResultsA total of 41 720 kits were distributed during the analysis period, ranging from 1254 in Zimbabwe to 27 678 in Zambia. The cost per kit distributed through the primary distribution approach was $4.27 in Zambia and $9.24 in Zimbabwe. The cost per kit distributed through the secondary distribution approach ranged from $6.46 in Zambia to $13.42 in South Africa, with a wider variation in the average cost at facility-level. From the time-and-motion observations, the counsellors spent between 20% and 44% of the observed workday on HIVST. Overall, personnel and test kit costs were the main cost drivers.ConclusionThe average costs of distributing HIVST kits were comparable across the four countries in our analysis despite wide cost variability within countries. We recommend context-specific exploration of potential efficiency gains from these facility-level cost variations and demand creation activities to ensure continued affordability at scale.

scholarly journals Implementation of HIV Self-Testing to Reach Men in Rural uMkhanyakude, KwaZulu-Natal, South Africa. a DO-ART Trial Sub Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Nsika Sithole ◽  
Maryam Shahmanesh ◽  
Olivier Koole ◽  
Meighan Krows ◽  
Torin Schaafsma ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Large Scale ◽  
Hiv Care ◽  
Confirmatory Test ◽  
Hiv Positive ◽  
Advisory Boards ◽  
Self Testing ◽  
Kwazulu Natal ◽  
Study Team

Background: KwaZulu–Natal, South Africa has one of the highest HIV prevalence rates globally. Persons <35 years and men have lower rates of HIV testing. HIV self-testing (HIVST) may overcome many barriers of facility-based HIV testing in order to identify HIV positive young persons and men and link them to care. We investigated whether HIVST distribution was a feasible approach to reach men and assessed the proportion of participants who reported their HIVST results, tested positive and linked to care.Methods: Teams comprised of a nurse, clinic research assistant, and recruiters distributed HIVST kits in rural uMkhanyakude, KwaZulu-Natal from August—November 2018 with a focus on testing men. Workplaces (farms), social venues, taxi ranks, and homesteads were used as HIVST kit distribution points following community sensitisation through community advisory boards and community leaders. HIVST kits, demonstration of use, and small incentives to report testing outcomes were provided. The Department of Health provided confirmatory testing and HIV care at clinics.Results: Over 11 weeks in late 2018, we distributed 2,634 HIVST kits of which 2,113 (80%) were distributed to persons aged <35 years, 2,591 (98%) to men and 356 (14%) to first time testers. Of the HIVST distributed, 2,107 (80%) reported their results to the study team, and 157 (7%) tested positive. Of persons who tested positive, 107/130 (82%) reported having a confirmatory test of which 102/107 (95%) were positive and initiated on ART. No emergencies or social harms were reported.Conclusion: Large scale distribution of HIVST kits targeting men in rural KwaZulu-Natal is feasible and highly effective in reaching men, including those who had not previously tested for HIV. While two-thirds of persons who tested HIV positive initiated ART, additional linkage strategies are needed for those who do not link after HIVST. HIVST should be used as a tool to reach men in order to achieve 95% coverage in the UNAIDS testing and care cascade in KwaZulu-Natal.

scholarly journals Is it lawful to offer HIV self-testing to children in South Africa?

2013 ◽  
Vol 14 (4) ◽  
pp. 151-154
Author(s):  
Ann Elaine Strode ◽  
H Van Rooyen ◽  
T Makusha
Keyword(s):  
South Africa ◽  
Hiv Prevention ◽  
Hiv Testing ◽  
Health Facility ◽  
Best Interests ◽  
Negative Consequences ◽  
Self Testing ◽  
Hiv Test ◽  
Hiv Prevention Strategies ◽  
Hiv Counselling And Testing

Health-facility-based HIV counselling and testing does not capture all children and adolescents who are at risk of HIV infection. Self-testing involves conducting an HIV test at home or in any other convenient space without the involvement of a third party. It is increasingly being argued that it should be incorporated into national HIV-prevention programmes as one of a range of HIV counselling and testing approaches. Although this model of HIV testing is being seen as a new way of reaching under-tested populations, no studies have been conducted on offering it to children. HIV self-tests are now available in South Africa and are sold without the purchaser having to be a certain age. Nevertheless, all HIV testing in children must comply with the norms set out in the Children’s Act (2005). Here we explore whether offering self-testing to children would be lawful, by outlining the four legal norms that must be met and applying them to self-HIV testing. We conclude that, although children above the age of 12 years could consent to such a test, there would be two potential obstacles. Firstly, it would have to be shown that using the test is in their best interests. This may be difficult given the potential negative consequences that could flow from testing without support and the availability of other testing services. Secondly, there would need to be a way for children to access pre- and post-test counselling or they would have to be advised that they will have expressly to waive this right. The tests are more likely to be lawful for a small sub-set of older children if: (i) it assists them with HIV-prevention strategies; (ii) they will be able to access treatment, care and support, even though they have tested outside of a health facility; and (iii) psychosocial support services are made available to them via the internet or cell phones.

scholarly journals Repeat HIV testing practices in the era of HIV self-testing among adults in KwaZulu-Natal, South Africa

PLoS ONE ◽  
2019 ◽  
Vol 14 (2) ◽  
pp. e0212343 ◽  
Author(s):  
Charlene Harichund ◽  
Pinky Kunene ◽  
Sinenhlanhla Simelane ◽  
Quarraisha Abdool Karim ◽  
Mosa Moshabela
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Self Testing ◽  
Kwazulu Natal ◽  
Testing Practices ◽  
Repeat Hiv Testing

scholarly journals Geographical variation in HIV testing in South Africa: Evidence from the 2017 national household HIV survey

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Sean Jooste ◽  
Musawenkosi Mabaso ◽  
Myra Taylor ◽  
Alicia North ◽  
Yolande Shean ◽  
...  
Keyword(s):  
South Africa ◽  
Hiv Testing ◽  
Secondary Analysis ◽  
District Level ◽  
Cluster Sampling ◽  
North West ◽  
Spatial Targeting ◽  
Home Based ◽  
Self Testing ◽  
Kwazulu Natal

Background: Identification of the geographical areas with low uptake of HIV testing could assist in spatial targeting of interventions to improve the uptake of HIV testing.Objectives: The objective of this research study was to map the uptake of HIV testing at the district level in South Africa.Method: The secondary analysis used data from the Human Sciences Research Council’s 2017 National HIV Prevalence, Incidence, Behaviour and Communication Survey, where data were collected using a multistage stratified random cluster sampling approach. Descriptive spatial methods were used to assess disparities in the proportion of those ever tested for HIV at the district level in South Africa.Results: The districts with the highest overall coverage of people ever having tested for HIV ( 85%) include West Rand in Gauteng, Lejweleputswa and Thabo Mofutsanyane in Free State, and Ngaka Modiri Molema in North-West. These provinces also had the least variation in HIV testing coverage between their districts. Districts in KwaZulu-Natal had the widest variation in coverage of HIV testing. The districts with the lowest uptake of HIV testing were uMkhanyakude (54.7%) and Ugu (61.4%) in KwaZulu-Natal and Vhembe (61.0%) in Limpopo. Most districts had a higher uptake of HIV testing amongst female than male participants.Conclusion: The uptake of HIV testing across various districts in South Africa seems to be unequal. Intervention programmes must improve the overall uptake of HIV testing, especially in uMkhanyakude and Ugu in KwaZulu-Natal and Vhembe in Limpopo. Interventions must also focus on enhancing uptake of HIV testing amongst male participants in most districts. Strategies that would improve the uptake of HIV testing include HIV self-testing and community HIV testing, specifically home-based testing.

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