Learn from Zambian health workers and experts about the success of HIV self-testing (HIVST), which is being rolled out across southern Africa by the Unitaid-funded and PSI-led HIV Self-Testing Africa (STAR) Initiative.
At PSI, we’re focused on making it easier to prevent, identify and treat HIV/AIDS and TB. We bring consumer voices and perspectives to the disease response, supporting public and private health providers to better respond to the needs of their clients and patients.
Through activities including HIV self-testing, cyber-education, community coaching and pharmacy services, we are working to bring healthcare for HIV and TB closer to those who need it, pairing human connection with new technologies to reach everyone in need with services that speak to their reality.
The Three Pillars of our Work in
In 2019, PSI’s HIV programming achieved the following impact for consumers across the globe:
HIV self-test kits distributed
people learn their HIV-positive status and access HIV treatment
young men provided with voluntary medical male circumcisions
As access to the internet expands in countries where we work, PSI is capitalizing on popular social media and messaging platforms to engage users. PSI has adapted face-to-face outreach for the web in the form peer outreach workers (aka cyber educators) trained to identify, inform and engage at-risk individuals within targeted populations using social media and provide referrals to services such as HIV testing.
In 2018, only 79% of people living with HIV knew that they had been infected, often because they lacked access to HIV testing services or didn’t want to visit a clinic. HIV self-testing is helping to overcome these barriers by giving people a discreet and convenient way to learn their HIV status. PSI works with stakeholders such as manufacturers, policymakers and donors to make self-test kits available and identify the most effective models of distributing test kits and linking users to on-going care.
Those newly diagnosed with HIV are often reluctant to disclose their status to their sexual partners. PSI carefully designs and implements culturally sensitive approaches to assisted partner notification to help our clients communicate with their partners and children and ensure that everyone at risk for infection is tested. By considering local norms about communicating sensitive information we build trust with our clients to tackle this challenging dialogue.
Circumcision reduces a man’s risk of acquiring HIV by as approximately 60% and can also protect his female sexual partners from cervical cancer. Persuading men to accept the procedure can be challenging, however. PSI works with market researchers to understand men’s journey from learning about voluntary medical male circumcision to accepting the procedure and develops tailored messaging designed to address their concerns.
People at high risk for HIV such as sex workers, men who have sex with men, transgender women and people who inject drugs face significant barriers to HIV services due to discrimination, criminalization and restrictive policies. PSI makes HIV prevention, diagnosis, care and treatment available at drop-in centers in order to make services available in locations that are convenient and safe for the target population.
‘I will choose when to test, where I want to test’: investigating young people’s preferences for HIV self-testing in Malawi and Zimbabwe
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Ability to understand and correctly follow HIV self-test kit instructions for use in Malawi and Zambia
Acceptability of woman-delivered HIV self-testing to the male partner, and additional interventions: a qualitative study of antenatal care participants in Malawi
With funding from USAID and the Global Fund, doctors in our Sun Clinic franchise in Myanmar offer low-cost TB treatment to their patients. Because these clinics are local and often easier to access than public clinics, patients greatly prefer receiving services there and consistently complete their TB treatment through the clinics.
The HIV Self-Testing Africa (STAR) project brings together WHO, academic institutions, implementing partners and donors to build the market for HIV self-testing (HIVST). When the project started in 2016, no developing countries were offering HIVST beyond a few small demonstration projects. By 2018, STAR had distributed almost 3 million self-test kits in 6 countries, and over 70 countries had adopted HIVST into their national HIV testing guidelines.
With funding from the Bill & Melinda Gates Foundation and Maverick Collective member Anu Khosla, PSI is focusing on some of the most challenging problems related to service uptake by looking at the problem from the patient’s point of view. Our Break the Cycle consortium in South Africa has conducted deep consumer insight research on young men at risk for HIV and is using human-centered design to develop new ways of supporting their uptake of HIV testing, prevention and treatment.