Webinar: HIV Self-Testing Scale Up and Health Systems

This piece was originally published on Population Services International’s blog.

Four decades into the HIV epidemic, an estimated 25% of people with HIV, more than 9 million people, remain undiagnosed. HIV self-testing (HIVST) is vital to close the HIV testing gap—by providing a discreet and convenient way for many who may not have been reached to know their status and access appropriate treatment.  

And as we continue to deal with the impact of COVID-19 on our healthcare systems, meeting the needs of people who live with or are at risk of HIV has never been more important. 

Unitaid and the HIV Self-Testing Africa (STAR) Initiative continue to explore the evidence, best practices and recommendations for global HIVST scale–up alongside the ATLAS consortium in their webinar series. After sharing where we currently stand globally in terms of policy and regulations and HIV self-testing products STAR then went on to discuss how to deliver HIVST to key populations and increase testing coverage among priority populations.  

But the learnings don’t stop there… 

In this fourth installment of the seven-part STAR Initiative HIVST webinar series, we heard from the following presenters and partners working on HIV self-test monitoring and evaluation:   

• Taurai Kambeu and Amber Sheets STAR/PSI  
• Smyrnov Pavlo for World Health Organization, Geneva   
• Aayush Solanki, STAR PSI  
• Mohammed Majam, Ezintsha, South Africa  

This session, titled: “Self-Testing Scale Up and Health Systems” explored how to integrate HIVST distribution into health systems, HIVST commodity quantification and more.   

Dive into to the full remarks below from the fourth webinar and explore some key takeaways from the discussion. 

HIGHLIGHTS:  

HIV Self Testing (HIVST) where individuals collect samples, perform and interpret tests results and themselves is now becoming a standard approach to HIV diagnosis in many high HIV-burden settings. 

• The inherent challenge of HIVST? Trying to piece together what happens to a test and to a tester once they have left a health facility to test in private. HIVST programs should not be compared to routine HTS, it is a supplementary strategy not a replacement. 
• Increasing focus of HIVST – poorly targeted HIVST will continue to miss people who don’t know their status, and be costly 
• There is no one size fits all solution for measuring impact and managing linkage into care for HIV self-test users. Instead, we need to have public health systems that make confirmatory testing, ART initiation and retention into care easier for the patient.  
• The WHO has published updates and new recommendations on HIV Testing Services (HTS) for a changing epidemic. A strong recommendation to offer HIV self-testing as an approach to HIV testing services based on moderate- quality evidence.  
• Exciting updates around the use of digital and mobile health technologies were also discussed. Widespread use of mobile devices creates opportunities for delivering HIVST services by generating demand, improving the delivery of HIVST kits and collecting information from clients 
• HIVST Monitoring was discussed in detail. Among key lessons learned, there is an urgent need to design and continue to innovate sustainable ways to measure distribution and linkages into care and prevention post HIVST uptake. The successful integration of HIVST indicators with national M&E and HMIS systems is seen as both pragmatic AND critical moving forward.  
• Finally, HIVST quantification and forecasting was explored. One recommendation? Ensuring the sustainability of HIVST programming can be supported by Ministry of Health involvement and coordination.   

And what’s next? STAR will be delving into HIVST demand creation and communications, community engagement and community-based monitoring of HIVST. You won’t want to miss it! 

To learn more, watch the previous webinars in the series here and follow the conversation next Thursday, 1 October 2020.