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A Global Review of HIV Self-testing: Themes and Implications

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Abstract

HIV self-test kits may have the potential to increase testing rates around the globe, and thereby lead to reductions in HIV-related incidence and mortality. However, the effectiveness of these self-test kits and the issues surrounding self-testing have been greatly debated in recent years. We conducted a literature review on the acceptability, feasibility, and effectiveness of HIV self-testing (HST) around the world. Of the 28 articles abstracted, several themes of HST were explored, including behavioral risk compensation, presence of counseling, uses of HST, ability to perform the self-test, sensitivity and specificity, concordance with confirmatory testing, perceptions surrounding HST, instruction and supervision, and cost. Overall, this literature review found that this diverse group of participants generally performed HST correctly with a few exceptions, were accepting of the test if available at a relatively low cost, and preferred the oral-based HST over the blood-based test.

Resumen

Los autoexámenes rápidos del VIH tienen el potencial de mejorar las tasas de la prueba alrededor del mundo, y así reducir la incidencia y mortalidad relacionada con el VIH. Sin embargo, la efectividad de los autoexámenes y otras cuestiones de estos autoexámenes se ha debatido en años recientes. Revisamos la literatura existente sobre la aceptabilidad, viabilidad, y efectividad del autoexamen del VIH alrededor del mundo. Hay 28 artículos incluidos en esta revisión, y muchos aspectos del autoexamen del VIH fueron explorados, incluso la compensación de riesgo, la presencia de consejería, los usos del autoexamen del VIH, la habilidad de realizar el autoexamen, la sensitividad y especificidad, la concordancia con la prueba confirmatoria, las percepciones acerca del autoexámen de VIH, la instrucción, la supervisión, y el precio. En general, esta revisión de literatura encontró que éste diverso grupo de participantes generalmente realizó los autoexámenes del VIH correctamente, aunque con algunas excepciones, y aceptó el autoexamen si esté estuviera disponible a un precio bajo. Los participantes prefirieron el autoexamen del VIH oral sobre el autoexamen del VIH de sangre.

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Acknowledgements

The authors would like to thank Teri Lynn Herbert for her assistance in performing the literature search for this review.

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Correspondence to Danielle R. Stevens.

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Stevens, D.R., Vrana, C.J., Dlin, R.E. et al. A Global Review of HIV Self-testing: Themes and Implications. AIDS Behav 22, 497–512 (2018). https://doi.org/10.1007/s10461-017-1707-8

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