Experiences Using and Organizing HIV Self-Testing: A Global Qualitative Systematic Review

Citation

Qin, Yilu; Han, Larry; Babbitt, Andrew; Walker, Jennifer S.; Liu, Fengying; Thirumurthy, Harsha; Tang, Weiming; & Tucker, Joseph D. (2018). Experiences Using and Organizing HIV Self-Testing: A Global Qualitative Systematic Review. AIDS, 32(3), 371-381. PMCID: PMC5758403

Abstract

OBJECTIVE: HIV self-testing (HIVST) is now officially recommended by the WHO, yet much of HIVST evidence to date has focused on quantitative data and hypothetical concerns. Effective scale up of HIVST in diverse local contexts requires qualitative data from experiences using and organizing HIVST. This qualitative systematic review aims to appraise and synthesize research evidence on experiences using and organizing HIVST.
METHODS: We conducted a systematic search of seven primary literature databases, four grey literature sources, and reference lists reporting qualitative evidence on HIVST. Data extraction and thematic analysis were used to synthesize findings. Quality of studies was assessed using the CASP tool. Confidence in review findings was evaluated using the CERQual approach. The review protocol was registered (CRD42015027607).
RESULTS: From 1,266 potential articles, we included eighteen. Four studies were conducted in low-income countries, three in middle-income countries, ten in high-income countries, and one in multiple countries. Generally, HIVST increased capacity to reach priority populations and expanded opportunities for service delivery. Self-testing was preferred to facility-based testing due to increased convenience and confidentiality, especially among stigmatized populations. HIVST decreased test-associated stigma compared to facility-based testing. HIVST generally empowered people because it provided greater control over individual testing needs. At the same time, HIVST rarely allowed husbands to coerce their wives to test.
CONCLUSIONS: This review suggests that HIVST should be offered as an additional HIV testing option in order to expand testing and empower testers. Adapting national policies to incorporate HIVST will be necessary to guide scale-up.

URL

http://dx.doi.org/10.1097/qad.0000000000001705

Reference Type

Journal Article

Year Published

2018

Journal Title

AIDS

Author(s)

Qin, Yilu
Han, Larry
Babbitt, Andrew
Walker, Jennifer S.
Liu, Fengying
Thirumurthy, Harsha
Tang, Weiming
Tucker, Joseph D.

PMCID

PMC5758403

ORCiD

Han, L. - 0000-0002-0577-9661