HIV Self-Testing in Southern Africa: Progress and Challenges

Abstract

Pitfalls of HIV testing in health care facilities include fears over loss of privacy and confidentiality. HIV self-testing represents an innovative strategy to expand access to HIV testing services in the general population and also to reach individuals at high risk for HIV who may not otherwise submit to HIV testing, including young people and key populations. We conducted a systematic review of observational studies done in southern African countries between the 1st January 2016 to 15th March 2018 on HIVST with focus on progress made and challenges observed. Thirteen (13) observational studies satisfied the inclusion criteria. These studies were published between January 2016 and March 2018 across five southern African countries namely Zambia (3), Malawi (2), South Africa (5), Zimbabwe (1), Botswana (1). There was also a study done in both Malawi and Zimbabwe (1). HIVST is highly acceptable in southern Africa despite challenges ranging from gender differences, acquisition of test kits, lack of pre-test and post-test counseling, potential social harm and inadequate ability to following user’s instructions.