Omar Sued

In this session, the experiences of several countries were presented, describing different opportunities to implement and expand the use of HIV self-test (HIVST) kits.

In Malawi, introducing HIVST through peer-distributors led to frequent experiences of FSWs feeling pressed to be tested and sharing their results. Regret was frequent. Care needs to be taken when introducing HIVST to ensure uptake is voluntary. Alternative strategies to the use of peer-distributors among FSW should be explored. In South Africa, during 5 months, 4355 tests were distributed, 62% reported results, and 9% were positive, demonstrating that the distribution and use of HIVST are feasible. In Burundi, a program focused on FSW reached 1606 individuals, with an HIV prevalence of 16%. In Vietnam, 2009 individuals were tested (80.5% were first-time testers, 5.1% were HIV+ and 98.1% initiated ART). In China, tests were distributed to MSM who could further distribute among partners and friends. Integrating social media with the secondary distribution of HIVST kits increased HIV testing coverage and case identification among MSM.

The session provided real examples of implementation, allowing an understanding of the benefits and potential risks and unintended consequences, such as coercion and risk of partner violence. The secondary distribution of tests through clients reached more positive cases, expanding the opportunities of identifying HIV-positive individuals and contributing to the 90-90-90 goal.