Community HIV Self-testing

HIV is the leading cause of mortality in Southern Africa, with HIV prevalence of 15-30% in the general population aged 15-49 years and only 45% of HIV+ people on Antiretroviral treatment (ART). HIV self-testing (HIVST) is a new approach that provides an opportunity to reach, test, and diagnose or prevent infection among hard to reach populations. Although HIVST has the potential to fill a gap in HIV testing modalities, it’s autonomous and private nature introduces challenges for supporting patients and effectively linking them into care. These challenges have made providers hesitant to support distribution of HIVST kits.

The Wits Reproductive Health and HIV Institute (Wits RHI) is a leading African research institute focusing on HIV, sexual and reproductive health. Wits RHI is a lead implementer in the UNITAID-funded Self-Test Africa (STAR) initiative programme to guide the implementation and scale up of potential distribution models in South Africa.

Aviro and Wits RHI piloted the use of the Ithaka platform to support HIV testers in inner city Johannesburg by providing a URL link to a data-free version of Ithaka when receiving their self-testing kit.  Study findings include:

  • 30% reported results and accessed post-test counselling, and
  • 100% those who reported positive were linked to facilities for care.

This study demonstrated that people self-testing for HIV are willing and able to use a web app based support tool during testing, self-reporting and linking to services. Based on this study, Wits RHI and HSTAR are working with Aviro to include a blood-based HIV test on their platform; to expand the user offering into WhatsApp; and to extend the use of Ithaka as the tool to be used across multiple distribution channels to increase HIVST uptake and linkage to care.