Augustine Choko of the Malawi-Liverpool Wellcome Trust Clinical Research Program in Malawi and her team assessed the uptake and accuracy of home-based supervised oral HIV self-testing in Malawi, proving that this approach is efficient in a high-prevalence, low-income setting.

Their findings published in this week’s PLoS Medicine, suggest that in urban African settings with high HIV prevalence, communities welcome self-testing for HIV combined with other HIV counseling and testing strategies.

The researchers explain:

“In settings where regular annual visits to every home by external VCT [voluntary counseling and testing] providers are not feasible, options based on self-testing may offer a more readily sustainable approach that can contribute towards Universal Access goals, provided that mechanisms can be identified to ensure that safety, accuracy, and post-test support are not unduly compromised.”

In an associated Perspective, Rochelle Walensky and Ingrid Bassett (who didn’t participate in the investigation) of Massachusets General Hospital, Boston, USA advises that relation to care must be shown before the success of oral HIV self-testing can be decided.

Walensky and Bassett state:

“Beyond making care accessible, the next phase of self-testing feasibility studies must evaluate the completion of the care cascade from testing to treatment to demonstrate true self-testing success.”

Written by Grace Rattue