April 04, 2013
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HIV self-testing preferred over facility-based testing

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Data from a systematic review suggest that HIV self-testing was acceptable and preferred by those in both high- and low-risk populations. In addition, the partners of those who self-tested also were more likely to self-test.

“The preference was largely driven by the fact that the oral self-tests are non-invasive, convenient, easy to swab and do not involve a finger stick or blood from your arm for a preliminary screen,” Nitika Pant Pai,MD, PhD, clinical researcher at the Research Institute of the McGill University Health Centre in Montreal, said in a press release. “A lot of people also wanted to take the oral self-test home to their partners.”

Pant Pai and colleagues evaluated 21 studies that took place from 2000 to 2012. Seven studies used an unsupervised self-test strategy and 14 studies used a supervised strategy, in which a health care professional was there for assistance. The supervised strategy studies included 4,890 participants and the unsupervised strategy studies included 7,512 participants. Most of studies used oral self-tests.

The acceptability ranged from 74% to 96% for both supervised and unsupervised methods. The specificity of the HIV self-tests was high across both strategies, but sensitivity was slightly lower in the unsupervised strategies. The feasibility of the tests varied, in that some populations, generally those in high-prevalence areas, were more likely report errors while self-testing. In one unsupervised study, data suggested that 96% of patients who tested positive said they would seek post-test counseling.

Most preferred oral tests compared with finger-stick tests, and most also preferred the tests to be available over-the-counter. Various groups were willing to pay $7 to $40 for the test.

“Thirty years into the HIV epidemic, there is no vaccine in sight,” Pant Pai said. “Treatment as a prevention strategy has been known to work, but uptake of HIV screening seems to be limited by a societal problem: HIV stigma and perceived discrimination.”

Disclosure: The researchers report no relevant disclosures.