HIVST for Key populations: Experiences from West Africa, Asia and Southern Africa

More than four decades into the HIV epidemic, an estimated 21% of people with HIV, more than 8.1 million people, remain undiagnosed. HIV self-testing is vital to close the HIV testing gap—as it provides a discreet and convenient way for many, who may not have had the opportunity, to know their status and access appropriate treatment.

Limited access to HIV testing not only prevents people living with HIV from accessing the treatment and care they need but also prevents high-risk HIV-negative individuals from accessing effective HIV-prevention services such as voluntary medical male circumcision and pre-exposure prophylaxis. Self-testing is an innovative way to overcome barriers that prevent priority populations from accessing HIV testing, populations currently not reached with conventional services.

In this second installment of a six-part STAR Initiative HIVST webinar series, we heard from presenters and partners working to increase access of HIVST for key populations in West Africa, Asia and Southern Africa. This presentation, titled: “HIVST for Key Populations” explored the role of HIV self-testing as it plays a critical role in ensuring the continuity of HIV services now and beyond the pandemic. 

Speakers included:

  • Frances Cowan, Liverpool School of Tropical Medicine
  • Anthony Vautier, Solthis
  • Maryam Shahmanesh, University College London
  • Kim Green, PATH
  • Julia Elkind, PSI Central Asia

We invite you to listen to their full remarks below, and explore some key takeaways from the discussion.

HIGHLIGHTS
 
  • Data from the STAR Initiative shows that HIVST is highly acceptable, feasible, safe, and scalable and reaches those traditionally harder to reach.
  • A study in Zimbabwe revealed that female sex workers’ (FSW) preferences for testing are context specific, this study showed that what works in one setting does not necessarily work in another. With this in mind, it is important to plan implementation programs in partnership with the sex workers themselves, giving them the power to choose what works best for them.
  • Accuracy studies show that FSW test more accurately than other members of the general population. This might be due to the fact that they might have been more frequently exposed to HIV testing and are feeling more empowered and self-confident to conduct the test themselves.
  • In West-Africa it was important to involve key populations and providers in the adaptation of HIVST distribution models through participatory approaches. HIVST modalities were successfully adapted to respect physical distancing during COVID-19 restrictions to maintain HIV testing services for key populations using digital technologies.
  • In Vietnam, among the key populations – specifically men who have sex with men (MSM) and first-time testers — privacy, confidentiality and being the first person to know their status were the main reasons for choosing HIVST over a different method of testing.
  • Amongst Vietnam key populations HIVST is found to be: a) highly acceptable and easy to use; b) preferred by those that have never tested before; c) preferred over facility-based testing–all of which ultimately resulted in high ART uptake, a portal to PrEP and was key to maintaining HIV testing access during COVID-19.
  • Due to widespread stigma in Kyrgyzstan, targeted online distribution models of HIVST through social media, have proven to be highly effective in reaching LGBTQ populations.

To learn more, watch the previous webinars in the series here and follow the conversation next Thursday, 17 September 2020.

Questions? Please contact Karin Hatzold, Associate Director and Project Director of HIV, at khatzold@psi.org to learn more.

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