Stimulating and shaping the market for HIV self-testing in Africa (STAR)

Weston Kandawasvika takes a HIV self-test, watched by his pregnant wife Patience Mbeve. Through Population Services International, Unitaid is funding the largest effort ever to kickstart wider use of HIV self-testing (Image: Eric Gauss/Unitaid)

Stimulating and shaping the market for HIV self-testing in Africa.

Challenges

Only an estimated 54 percent of all people living with HIV know their status. To meet the UNAIDS target that 90 percent of people living with HIV know their status by 2020, there is a need to move beyond conventional testing, and invest in strategies such as self-testing.

Solutions

HIV self-testing (HIVST) provides a platform to reach more first-time testers and facilitate frequent re-testing, particularly among those with high ongoing risk of contracting HIV.

The “HIV Self-testing Africa” (STAR) grant aims to evaluate the acceptability, feasibility, and impact of self-testing among different populations in Malawi, Zambia, and Zimbabwe, and generate information about how products for HIVST can be distributed effectively, ethically, and efficiently. It aims to increase equitable access to HIVST by creating a healthy, competitive market for quality-assured HIVST products to reach global HIV treatment and prevention targets.

Evidence gathered will be used to inform the creation of implementation tools for HIVST, shape global normative guidance and to drive change in policy and programming decisions across countries.

“We have evidence now that demand and acceptability of HIV self-testing is high when offered at community and facility level. We are reaching populations, such as men, adolescents and key populations who would otherwise not access HIV testing services and being linked to HIV care, treatment and prevention services”

Dr Karin Hatzold, Project Director, Population Services International (PSI)

Progress so far

The STAR grant has played a critical role in demonstrating the high potential of HIVST. The preliminary results show very high uptake among first-time testers and among people who were not previously reached by HIV testing services. Some 21– 31 percent of those using self-tests were first-time testers.

WHO guidance on HIVST was released in December 2016, and national HIVST policies were established in all three project countries.

To inform manufacturers and other stakeholders, a global analysis of the HIVST market, and a detailed model for estimating market size have been published.

The impact we are seeking

By increasing the number of people who know their HIV status, self-testing has the potential to turn the course of the epidemic.

HIVST can help to increase the overall efficiency of HIV testing in resource-limited settings and can support increased linkage to care for those found to be HIV positive. Those who test negative can be referred to other prevention services, such as voluntary medical male circumcision (VMMC) and pre-exposure prophylaxis (PrEP).



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