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Scaling up HIV self-testing in sub-Saharan Africa: a review of technology, policy and evidence.

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Indravudh, Pitchaya, Choko, Augustine and Corbett, Elizabeth (2018) 'Scaling up HIV self-testing in sub-Saharan Africa: a review of technology, policy and evidence.'. Current Opinion in Infectious Diseases, Vol 31, Issue 1, pp. 14-24.

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Abstract

PURPOSE OF REVIEW

HIV self-testing (HIVST) can provide complementary coverage to existing HIV testing services and improve knowledge of status among HIV-infected individuals. This review summarizes the current technology, policy and evidence landscape in sub-Saharan Africa and priorities within a rapidly evolving field.

RECENT FINDINGS
HIVST is moving towards scaled implementation, with the release of WHO guidelines, WHO prequalification of the first HIVST product, price reductions of HIVST products and a growing product pipeline. Multicountry evidence from southern and eastern Africa confirms high feasibility, acceptability and accuracy across many delivery models and populations, with minimal harms. Evidence on the effectiveness of HIVST on increased testing coverage is strong, while evidence on demand generation for follow-on HIV prevention and treatment services and cost-effective delivery is emerging. Despite these developments, HIVST delivery remains limited outside of pilot implementation.

SUMMARY
Important technology gaps include increasing availability of more sensitive HIVST products in low and middle-income countries. Regulatory and postmarket surveillance systems for HIVST also require further development. Randomized trials evaluating the effectiveness and cost-effectiveness under multiple distribution models, including unrestricted delivery and with a focus on linkage to HIV prevention and treatment, remain priorities. Diversification of studies from west and central Africa and around blood-based products should be addressed.

Item Type: Article
Subjects: W General Medicine. Health Professions > W 83 Telemedicine (General)
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.1 Diagnosis
Faculty: Department: Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI): https://doi.org/10.1097/QCO.0000000000000426
Depositing User: Stacy Murtagh
Date Deposited: 18 Jan 2018 16:53
Last Modified: 19 Jan 2018 10:32
URI: https://archive.lstmed.ac.uk/id/eprint/8101

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