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J Clin Microbiol. 2019 Aug 28. pii: JCM.00257-19. doi: 10.1128/JCM.00257-19. [Epub ahead of print]

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

Author information

1
Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University.
2
Emory University School of Medicine.
3
Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University asiegle@emory.edu.

Abstract

HIV self-testing (HIVST) provides an at-home option to counter the barriers that patients face with testing performed in a healthcare setting. HIVST has gradually increased in popularity in a time when social media and tech-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 demonstrated the ability to reach at-risk individuals who might otherwise rarely test. The paradigm of self-testing, however, introduces new challenges such as decreased performance compared to testing performed in a healthcare setting, the role of counseling for receiving test results, and difficulty of linking to care. After discussing the performance of oral fluid vs. 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.

PMID:
31462549
DOI:
10.1128/JCM.00257-19

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