Bringing HIV Self-Testing to Scale in the United States: a Review of Challenges, Potential Solutions, and Future Opportunities.

TitleBringing HIV Self-Testing to Scale in the United States: a Review of Challenges, Potential Solutions, and Future Opportunities.
Publication TypePublication
Year of Publication2019
AuthorsSteehler K, Siegler AJ
JournalJ Clin Microbiol
Volume57
Issue11
Date Published2019 11
ISSN1098-660X
KeywordsDiagnostic Self Evaluation, Female, Health Plan Implementation, HIV Infections, Homosexuality, Male, Humans, Male, Mass Screening, Mouth, Patient Acceptance of Health Care, Public Health, Reagent Kits, Diagnostic, United States
Abstract

<p>HIV self-testing (HIVST) provides an at-home option to counter the barriers that patients face with testing performed in health care settings. HIVST has gradually increased in popularity in a time when social media and technology-based solutions are preferred. In this paper, we consider the aspects of self-testing that merit its integration into HIV testing and prevention systems in the United States. Several elements favor self-testing for large-scale implementation, including ease of use, convenience, potential for integration with mobile health (mHealth), and availability for various modes of distribution. HIVST has a demonstrated ability to reach at-risk individuals who otherwise rarely test. The paradigm of self-testing, however, introduces new challenges, including lesser test performance relative to that in health care settings, nonstandard counseling following receipt of test results, and difficulty in providing linkage to care. After discussing the performance of oral fluid versus blood-based HIVST, we review data regarding acceptability of HIVST, offer insights into counseling and linkage to care for HIVST, and provide examples of novel applications of and future research directions for HIVST.</p>

DOI10.1128/JCM.00257-19
Alternate JournalJ Clin Microbiol
PubMed ID31462549
PubMed Central IDPMC6813024
Grant ListP30 AI050409 / AI / NIAID NIH HHS / United States
R01 MH114692 / MH / NIMH NIH HHS / United States
U19 HD089881 / HD / NICHD NIH HHS / United States