Dorlim Moiana Uetela

In this session, updates on self-testing from the WHO Global HIV, Hepatitis and STI Programmes were presented, as well as innovations, success stories, and challenges with HIV self-test in Canada, Malaysia, and United Kingdom (UK).

Cheryl JOHNSON from World Health Organization, Switzerland, stated that “Self-testing is now the new normal” and underlined that other disease areas benefit from self-testing and self-care leveraged from indirect evidence from the HIV field. However, there is still a need to shift from specific self-testing programs to policies and platforms that are cross-cutting, to which advocacy and community engagement are critical. JOHNSON also identified virtual intervention platforms as vital for an effective scale-up of self-testing. According to Chris DRAENOS from Community-Based Research Center (CBRC), Canada, HIV self-test is feasible and highly acceptable amongst GBT2Q population, using both mail-home programs as well as venue-based and community-based distribution. Davindren THARMALINGAM, from Malaysian AIDS Council presented the JOM TEST Program, the first HIV Self-Testing pilot study conducted in Malaysia for people vulnerable to HIV infection, and identified challenges such as COVID-19 restrictions and movement control orders by the government, high demand in the first 2 months, test kits procurement delayed due to shipment. On self-testing and self-sampling programs from the UK, Charles WITZEL from University College London, UK, stated that self-sampling is available and currently a cornerstone of HIV testing. However, it has not been broadly embraced yet, limiting its potential.

This session underlined the need for investing in self-care and self-testing as an important approach to optimize the health system capacity to provide health care, including HIV prevention, testing and treatment for all. However, the broadly available material for self-testing is contingent on their mass production and distribution to those in need. Implementation scientists are encouraged to develop innovative strategies to offer self-test to those in need in different contexts to empower them to know their HIV status and act accordingly, for individual and public health benefit.

Roman Shrestha

In this session, the panelists discussed up-to-date science around self-testing and self-sampling technologies for HIV, STIs, and hepatitis. They highlighted how self-testing and self-sampling guidelines could be translated into actual implementation at scale.

Cheryl Johnson discussed the current state of self-testing and self-sampling approaches to enhance integrated HIV, STIs, and hepatitis services. She highlighted the many benefits of these approaches and the need to accelerate national policies, manufacturer development, and access to affordable products to scale up the uptake. Christopher Draenos discussed the findings and lessons learned from multiple self-sampling and self-testing studies conducted by the Community-Based Research Centre in Canada. These findings demonstrated the feasibility and acceptability of using mail-home, venue-based, and community-based HIVST distribution programs among key populations in Canada. Davindren Tharmalingam provided an overview of Malaysia’s first HIV self-testing program, known as the Jom Test. Findings for the pilot study demonstrated high feasibility and acceptability of the platform to increase uptake of HIVST among the key population in Malaysia, and highlighted some key implementation challenges (e.g., the impact of COVID-19, lack of staff, and test kits, data verification, subsequent linkage to care). Charles Witzel presented findings from two self-testing and self-sampling programs (SELPHI and PANTHEON) aimed at improving HIV testing in key populations (e.g., MSM, TGW) in the UK.

Self-testing and self-sampling are innovative techniques that empower individuals by allowing them to get tested in private, at a time and place of their choosing, and when and where they are comfortable. They have the potential to overcome many of the identified barriers in accessing testing and subsequently linking them to care. However, there is a need to leverage available evidence (even when indirect) to accelerate policy and implementation for further scale-up of these promising tools.