Can self-testing end the HIV/AIDS epidemic?

Nearly 5 years ago, the FDA Blood Advisory Products Committee (BPAC), approved the world’s first self-test for HIV, produced by OraQuick®. Little did the BPAC know that their approval would catalyze a global HIV self-testing phenomena. Key global agencies and foundations soon put their energies behind HIV self-testing; prominent among them were the WHO, the Gates Foundation, and the UNITAID [1].  In many countries, newer studies were initiated to generate evidence at scale in support of this new strategy [1]. This meant offering self-testing to massive numbers of participants to prove its effectiveness in different contexts.

In 2016, WHO released its first self-testing guidelines, which recommended self-testing as an alternative to conventional methods, and precipitated a catalytic effect [2]. Promising rapid point-of-care tests were re-incarnated as self-tests. Communities hit hardest by the epidemic demanded expedited approvals of HIV self-tests. Demand for affordable self-tests grew. Health agencies were prepared to support implementation of self-testing in their countries. Today, 44-plus countries have self-testing friendly policies in development. In 2017, HIV self-testing featured prominently in the International AIDS Society agenda [3]; self-testing as a concept and a strategy to end the HIV epidemic had finally arrived.

The question that now comes to mind is whether HIV self-testing will end the HIV epidemic. Let’s examine HIV self-testing in detail.

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