Home tests could be key to curb HIV spread

Research shows HIV self-testing removes much of the fear and stigma associated with the test

Making self-testing kits for HIV widely available could help reduce the global epidemic of AIDS, according to a new study led by an Indian-origin scientist.

The research which analysed data from many countries, including India, shows HIV self-testing removes much of the fear and stigma associated with being tested for the deadly disease.

The study by Dr Nitika Pant Pai from The Research Institute of the McGill University Health Centre (RI-MUHC) is the first of its kind and could pave the way for early detection and treatment around the world, thereby reducing transmission.

"Thirty years into the HIV epidemic, there is no vaccine in sight. Treatment as a prevention strategy has been known to work, but uptake of HIV screening seems to be limited by a societal problem: HIV stigma and perceived discrimination," said Pant Pai, first author of the study.

According to UNAIDS, 50% of people living with HIV worldwide are unaware of their HIV status and about 2.5 million people become infected every year.

Pant Pai believes that access to an HIV self-test linked to expedited counselling systems will help expand access to screening and reduce judgement and perceived attitudes around HIV testing.

Self-tests are performed in oral fluid samples from the gum lining of the mouth in the privacy of one's home. They are non-invasive, convenient, ensure confidentiality and can provide results within 20 minutes.

The results are self-interpreted however, and require confirmation at a medical clinic if positive.

Several studies have been conducted to determine the best methods of making a self-test with linked counselling and referral services available in various African, North American and European settings.

Pant Pai and her colleagues decided to look at the global evidence on self-testing strategies based on acceptability, feasibility and accuracy and success with linkages to care.

They examined 21 worldwide studies and found that two distinct self-testing strategies have been tried: supervised self-testing, and unsupervised self-testing.

Most of the data came from studies carried out in high-income settings including the US, Canada, Spain and the Netherlands, as well as Kenya, Singapore, Malawi and India.

Across the various studies, researchers observed that acceptability was very high for both self-testing strategies.

They also found evidence that people preferred self-testing to facility-based testing and oral self-testing to blood-based self-testing.

"The preference was largely driven by the fact the oral self-tests are non-invasive, convenient, easy to swab and do not involve a finger stick or blood from your arm for a preliminary screen," said Pant Pai in the study published in PLoS Medicine journal.