WHO to develop guidance on HIV self-testing in 2016
11 January 2016 – WHO is developing new guidance on HIV self-testing as part of the updated Consolidated guidelines on HIV testing services, which are planned for release in December 2016. While a formal recommendation on HIV self-testing has not yet been issued, WHO has already provided programmatic guidance and encouraged countries to start piloting and conducting demonstration projects to evaluate self-testing in their particular contexts.
The United Nations has set targets to diagnose 90% of all people with HIV by 2020 towards the goal of ending the HIV epidemic by 2030. Currently it is estimated that only 54% of people with HIV are aware of their infection. In order to close the gap, countries are now required to rapidly increase access to and uptake of HIV testing services; particularly among populations with lowest coverage and highest risk. Self-testing has been proposed as an innovative way to contribute to this effort. The method is viewed as particularly effective at increasing uptake of testing among people at risk or living with HIV who may not otherwise seek HIV testing.
What is HIV self-testing?
HIV self-testing is a process in which people can collect their own specimen (saliva or blood), then perform a test and interpret the result, often in private or with someone they trust.
WHO's existing guidance states that HIV self-testing does not provide a HIV-positive diagnosis; any reactive (positive) self-test result should be confirmed using a validated national testing algorithm by a health-care provider. However, a person testing negative through HIV self-testing does not need to have this result confirmed as HIV self-tests are highly sensitive.
There are many possible approaches to implementing HIV self-testing, which vary in the level of support provided and how and where rapid diagnostic tests for HIV self-testing are made available to potential users. Evidence is already emerging that HIV self-testing is acceptable to many diverse groups in a variety of settings. Furthermore, it is generally accurate when performed with regulated and quality rapid diagnostic tests. When provided in conjunction with adequate instructions for use and post-test support services, self-testing is also effective, efficient with very few adverse outcomes noted with current implementation experience.
Many countries have already introduced, or plan to introduce HIV self-testing as part of their national policy and regulatory frameworks. WHO’s planned guidance aims to further assist countries in introducing self-testing as part of their national HIV testing strategies, particularly in reaching populations and settings that remain under-served.