HIV self-testing (HIVST) allows individuals to interpret and report their own test results, thus decentralizing testing. Yet, this decentralization can make it difficult to verify self-testing results, which is important for linkage to care and surveillance. The aim of this systematic review is to summarize methods for verifying HIVST use and results. We followed guidance from the Cochrane Handbook 5.1 on systematic reviews. We searched four journal databases (PubMed, Embase, Scopus, and Cochrane Library), one clinical trials database (ClinicalTrials.gov), two conference abstract databases (International AIDS Society and Conference on Retroviruses and Opportunistic Infections) and one gray literature database (OpenGrey). We included studies that verified opening of kits or test results. Two researchers independently screened articles and extracted data regarding HIVST location, method of verification, who performed verification, proportion of results verified, and primary or secondary kit distribution. The search yielded 3853 unique citations, of which 40 contained information on HIVST verification and were included. Among these 40 studies, 13 were in high-income countries, 16 were in middle-income countries, and 11 were in low-income countries. Seventeen studies included key populations and two focused on youth. Three methods verified results: supervision by a health provider, returning used test kits, and electronic transmission of photographs. One method verified opening of kits using Bluetooth sensors. Although HIVST has increased worldwide, strategies to verify self-testing results remain limited. These findings suggest a need for additional innovative strategies for verifying HIVST use and results and linkage of self-testing results to surveillance and care systems.
Get full access to this article
View all access options for this article.
References
1.
World Health Organization (WHO). Guidelines on HIV Self-Testing and Partner Notification. Geneva, Switzerland: WHO; 2016.
2.
The Joint United Nations Programme on HIV/AIDS (UNAIDS). Knowledge Is Power—Know Your Status, Know Your Viral Load. Geneva, Switzerland: UNAIDS; 2018.
3.
The Joint United Nations Programme on HIV/AIDS (UNAIDS). 90-90-90 An Ambitious Treatment Target to Help End the AIDS Epidemic. Geneva, Switzerland: UNAIDS; 2014.
4.
The Joint United Nations Programme on HIV/AIDS (UNAIDS). Confronting Discrimination. Geneva, Switzerland: UNAIDS; 2017.
5.
QinY, HanL, BabbittA, et al.Experiences using and organizing HIV self-testing. AIDS, 2018; 32:371–381.
6.
CambianoV, FordD, MabuguT, et al.Assessment of the potential impact and cost-effectiveness of self-testing for HIV in low-income countries. J Infect Dis, 2015; 212:570–577.
7.
LankowskiAJ, SiednerMJ, BangsbergDR, et al.Impact of geographic and transportation-related barriers on HIV outcomes in sub-Saharan Africa: A systematic review. AIDS Behav, 2014; 18:1199–1223.
8.
ChenW, ZhouF, HallBJ, et al.Is there a relationship between geographic distance and uptake of HIV testing services? A representative population-based study of Chinese adults in Guangzhou, China. PLoS One, 2017; 12:e0180801.
9.
TafumaTA, MahachiN, DziwaC, et al.Barriers to HIV service utilisation by people living with HIV in two provinces of Zimbabwe: Results from 2016 baseline assessment. South Afr J HIV Med, 2018; 19:721.
10.
YehiaBR, StewartL, MomplaisirF, et al.Barriers and facilitators to patient retention in HIV care. BMC Infect Dis, 2015; 15:246.
11.
NakigoziG, MakumbiFE, KigoziG, et al.Barriers to utilization of HIV care services among adolescents and young adults in Rakai, Uganda: The role of economic strengthening. Global Social Welfare, 2015; 2:105–110.
12.
KalibalaS, TunW, CherutichP, et al.Factors associated with acceptability of HIV self-testing among health care workers in Kenya. AIDS Behav, 2014; 18(Suppl. 4):S405–S414.
13.
GichangiA, WambuaJ, MutwiwaS, et al.Impact of HIV self-test distribution to male partners of ANC clients. J AIDS, 2018; 79:467–473.
14.
OrtbladK, Kibuuka MusokeD, NgabiranoT, et al.Direct provision versus facility collection of HIV self-tests among female sex workers in Uganda: A cluster-randomized controlled health systems trial. PLoS Med, 2017; 14:e1002458.
15.
FogelJM, ZhangY, PalumboPJ, et al.Use of antiretroviral drug testing to assess the accuracy of self-reported data from HIV-infected people who inject drugs. AIDS Behav, 2019; 23:2101–2108.
16.
HigginsJ, GreenS. Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration. Version 5.1.0. The Cochrane Collaboration, 2011. Available at: http://handbook.cochrane.org (Last accessed February25, 2019).
17.
Covidence Systematic Review Software, Veritas Health Innovation, Melbourne, Australia. Available at: www.covidence.org (Last accessed April9, 2019).
18.
StataCorp. Stata Statistical Software. Version 15. College Station, TX: StataCorp LLC; 2017.
19.
MunnZ, MoolaS, LisyK, et al.Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and incidence data. Int J Evid Based Healthc, 2015; 13:147–153.
20.
World Bank List of Economies. The World Bank, June 2018. Available at: http://databank.worldbank.org/data/download/site-content/CLASS.xls (Last accessed April9, 2019).
21.
BirrellF, StauntonS, DebattistaJ, et al.Pilot of non-invasive (oral fluid) testing for HIV within a community setting. Sexual Health, 2010; 7:11–16.
22.
ChokoAT, DesmondN, WebbEL, et al.The uptake and accuracy of oral kits for HIV self-testing in high HIV prevalence setting: A cross-sectional feasibility study in Blantyre, Malawi. PLoS Med, 2011; 8:e1001102.
23.
NgOT, ChowAL, LeeVJ, et al.Accuracy and user-acceptability of HIV self-testing using an oral fluid-based HIV rapid test. PLoS One, 2012; 7:e45168.
24.
GaydosCA, HsiehYH, HarveyL, et al.Will patients “opt in” to perform their own rapid HIV test in the emergency department?. Ann Emerg Med, 2011; 58(Suppl. 1):S74–S78.
25.
Carballo-DiéguezA, BalanI, FrascaT, et al.Use of a rapid HIV home test to screen potential sexual partners prevents HIV exposure in a high-risk sample of MSM. J Int AIDS Soc, 2012; 15:153–154.
26.
AsiimweS, OloyaJ, SongX, et al.Accuracy of un-supervised versus provider-supervised self-administered HIV testing in Uganda: A randomized implementation trial. AIDS Behav, 2014; 18:2477–2484.
27.
MavedzengeSN, SibandaE, MavengereY, et al.Supervised HIV self-testing to inform implementation and scale up of self-testing in Zimbabwe. J Int AIDS Soc, 2015; 18(Suppl. 4):96.
28.
ChokoAT, MacPhersonP, WebbEL, et al.Uptake, accuracy, safety, and linkage into care over two years of promoting annual self-testing for HIV in Blantyre, Malawi: A community-based prospective study. PLoS Med, 2015; 12:e1001873.
29.
ChokoAT, MacPhersonP, WebbEL, et al.One year outcomes following community-based HIV self-testing: A prospective study in Malawi. Top Antivir Med, 2014; 22:73.
30.
GreavesL, SymondsM, SaundersJ, et al.Is offering STI & HIV self-sampling kits to men who have sex with men (MSM) in a London sauna a feasible and acceptable way to widen access to testing?. HIV Med, 2014; 15:102–103.
31.
MacPhersonP, LallooDG, WebbEL, et al.Effect of optional home initiation of HIV care following HIV self-testing on antiretroviral therapy initiation among adults in Malawi: A randomized clinical trial. JAMA, 2014; 312:372–379.
32.
TaoJ, LiMY, QianHZ, et al.Home-based HIV testing for men who have sex with men in China: A novel community-based partnership to complement government programs. PLoS One, 2014; 9:e102812.
33.
WangZ, LauJTF, IpM, et al.A randomized controlled trial evaluating efficacy of promoting a home-based HIV self-testing with online counseling on increasing HIV testing among men who have sex with men. AIDS Behav, 2018; 22:190–201.
34.
KelvinEA, GeorgeG, MwaiE, et al.A randomized controlled trial to increase HIV testing demand among female sex workers in Kenya through announcing the availability of HIV self-testing via text message. AIDS Behav, 2019; 23:116–125.
35.
KelvinEA, GeorgeG, MwaiE, et al.Offering self-administered oral HIV testing to truck drivers in Kenya to increase testing: A randomized controlled trial. AIDS Care, 2018; 30:47–55.
36.
KurthAE, ClelandCM, ChhunN, et al.Accuracy and acceptability of oral fluid HIV self-testing in a general adult population in Kenya. AIDS Behav, 2016; 20:870–879.
37.
VolkJE, LippmanSA, GrinsztejnB, et al.Acceptability and feasibility of HIV self-testing among men who have sex with men in Peru and Brazil. Int J STD AIDS, 2016; 27:531–536.
38.
ShivkumarPV, SarkarA, MburuG, et al. Assessing the concordance of supervised self-testing using an oral fluid-based HIV rapid testing method among pregnant women in rural India. Presented at: 21st International AIDS Conference, July 21, 2016, Durban, South Africa.
39.
SmithP, WallaceM, BekkerL-G. Investigating feasibility and acceptability of a rapid HIV self-testing device in adolescents and young adults. Presented at: 21st International AIDS Conference, July 19, 2016, Durban, South Africa.
40.
PaiN, EsmailA, MaratheG, et al. Impact of a digital HIV self-testing strategy on referrals, new infections and linkage to care: Results from a transition to scale cohort study in South Africa. Presented at: 22nd International AIDS Conference, 2018, Amsterdam, Netherlands.
41.
Martinez PerezG, SteeleSJ, GovenderI, et al.Supervised oral HIV self-testing is accurate in rural KwaZulu-Natal, South Africa. Trop Med Int Health, 2016; 21:759–767.
42.
PasipamireL, DubeL, MabhenaE, et al. Successful implementation of HIV self-testing in the rural Shiselweni region of Swaziland. Presented at: 22nd International AIDS Conference, July 25, 2018, Amsterdam, Netherlands.
43.
JantarapakdeJ, HimmadK, SungsingT, et al.Online supervised HIV self-testing identified high HIV yield among Thai men who have sex with men and transgender women. J Int AIDS Soc, 2018; 21(S6):e126–e127.
44.
SaundersJ, BrimaN, OrzolM, et al.Prospective observational study to evaluate the performance of the BioSure HIV self-test in the hands of lay users. Sex Transm Infect, 2018; 94:169–173.
45.
MacGowanRJ, ChavezPR, GravensL, et al.Pilot evaluation of the ability of men who have sex with men to self-administer rapid HIV tests, prepare dried blood spot cards, and interpret test results, Atlanta, Georgia, 2013. AIDS Behav, 2018; 22:117–126.
46.
StephensonR, FreelandR, SullivanSP, et al.Home-based HIV testing and counseling for male couples (project nexus): A protocol for a randomized controlled trial. JMIR Res Protoc, 2017; 6:e101.
47.
StephensonR, MethenyN, SharmaA, et al.Providing home-based HIV testing and counseling for transgender youth (project moxie): Protocol for a pilot randomized controlled trial. JMIR Res Protoc, 2017; 6:e237.
48.
FloydS, ShanaubeK, SchaapA, et al.Linkage to HIV care following HIV self-testing: A cluster randomised trial of community-based distribution of oral HIV self-test kits nested in four HPTN 071 communities in Zambia. J Int AIDS Soc, 2018; 21(S6):e25148.
49.
BrownLJ, TanKS, GuerraLE, et al.Using behavioural insights to increase HIV self-sampling kit returns: A randomized controlled text message trial to improve England's HIV self-sampling service. HIV Med, 2018; 19:585–596.
50.
ChokoAT, FieldingK, StallardN, et al.Investigating interventions to increase uptake of HIV testing and linkage into care or prevention for male partners of pregnant women in antenatal clinics in Blantyre, Malawi: Study protocol for a cluster randomised trial. Trials, 2017; 18:349.
51.
DovelK, ShabaF, NyirendaM, et al.Evaluating the integration of HIV self-testing into low-resource health systems: Study protocol for a cluster-randomized control trial from EQUIP Innovations. Trials, 2018; 19:498.
52.
HatzoldK, MutsetaM, SibandaE, et al. Closing the HIV testing gap: Facility-based integration of HIV self-testing, a way to improve testing coverage, yield and efficiency of client-initiated HIV testing services in Zimbabwe. Presented at: 9th IAS Conference on HIV Science, July 25, 2017, Paris, France.
53.
NanfukaM, ChokoA, BirungiJ, et al. Accelerating progress towards the first 90 among men: A trial of the peer-based distribution of HIV self-test kits in Bulisa, Uganda. Presented at: 9th IAS Conference on HIV Science, July 25, 2017, Paris, France.
54.
SibandaEL, MutsetaM, HatzoldK, et al. Community-based distribution of HIV self-test kits: Results from a pilot of door-to-door distribution of HIV self-test kits in one rural Zimbabwean community. Presented at: 21st International AIDS Conference, July 2016, Durban, South Africa.
55.
JinX, XiaoD, XiuX, et al.Internet-based self-testing model—“Easy Test”: A crosssectional survey targeting MSM who never tested before in 14 provinces of China. J Int AIDS Soc, 2018; 21(S6):e25148.
56.
MustanskiB, MadkinsK, GreeneGJ, et al.Internet-based HIV prevention with at-home sexually transmitted infection testing for young men having sex with men: Study protocol of a randomized controlled trial of keep it up! 2.0. JMIR Res Protoc, 2017; 6:e1.
57.
OperarioD. mHealth and HIV Self-testing. Available at: https://clinicaltrials.gov/show/NCT03569462 (Last accessed April30, 2019).
58.
TangW, WeiC, CaoB, et al.Crowdsourcing to expand HIV testing among men who have sex with men in China: A closed cohort stepped wedge cluster randomized controlled trial. PLoS Med, 2018; 15:e1002645.
59.
ZhongF, TangW, ChengW, et al.Acceptability and feasibility of a social entrepreneurship testing model to promote HIV self-testing and linkage to care among men who have sex with men. HIV Med, 2017; 18:376–382.
60.
WrayTB, ChanPA, SimpanenE, et al.A pilot, randomized controlled trial of HIV self-testing and real-time post-test counseling/referral on screening and preventative care among men who have sex with men. AIDS Patient Care STDs, 2018; 32:360–367.
61.
RossJ, AkiyamaMJ, SlawekD, et al.Undocumented african immigrants' experiences of HIV testing and linkage to care. AIDS Patient Care STDs, 2019; 33:336–341.
62.
MamaryEM, ToevsK, BurnworthKB, et al.Developing consumer involvement in rural HIV primary care programmes. Health Expect, 2004; 7:157–164.
63.
DanielsJ, RosengrenL, YoungS, et al.Will men who have sex with men use short-messaging services to send photos of completed HIV self-tests to researchers?. J Assoc Nurses AIDS Care, 2016; 27:722–726.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
