title: HIV self-testing could "revolutionize testing in South Africa, but it has got to be done properly": perceptions of key stakeholders.
abstract: South Africa bears the world's largest burden of HIV with over 6.4 million people living with the virus. The South African government's response to HIV has yielded remarkable results in recent years; over 13 million South Africans tested in a 2012 campaign and over 2 million people are on antiretroviral treatment. However, with an HIV & AIDS and STI National Strategic Plan aiming to get 80 percent of the population to know their HIV status by 2016, activists and public health policy makers argue that non-invasive HIV self-testing should be incorporated into the country HIV Counseling and Testing [HCT] portfolios. In-depth qualitative interviews (N = 12) with key stakeholders were conducted from June to July 2013 in South Africa. These included two government officials, four non-governmental stakeholders, two donors, three academic researchers, and one international stakeholder. All stakeholders were involved in HIV prevention and treatment and influenced HCT policy and research in South Africa and beyond. The interviews explored: interest in HIV self-testing; potential distribution channels for HIV self-tests to target groups; perception of requirements for diagnostic technologies that would be most amenable to HIV self-testing and opinions on barriers and opportunities for HIV-linkage to care after receiving positive test results. While there is currently no HIV self-testing policy in South Africa, and several barriers exist, participants in the study expressed enthusiasm and willingness for scale-up and urgent need for further research, planning, establishment of HIV Self-testing policy and programming to complement existing facility-based and community-based HIV testing systems. Introduction of HIV self-testing could have far-reaching positive effects on holistic HIV testing uptake, giving people autonomy to decide which approach they want to use for HIV testing, early diagnosis, treatment and care for HIV particularly among hard-to reach groups, including men.
authors.affiliation: Human Sciences Research Council, Durban, South Africa.
authors.forename: Tawanda
authors.initials: T
authors.lastname: Makusha
authors.affiliation: School of Public Health, University of Western Cape, Cape Town, South Africa.
authors.forename: Lucia
authors.initials: L
authors.lastname: Knight
authors.affiliation: Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
authors.forename: Miriam
authors.initials: M
authors.lastname: Taegtmeyer
authors.affiliation: Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
authors.forename: Olivia
authors.initials: O
authors.lastname: Tulloch
authors.affiliation: Human Sciences Research Council, Durban, South Africa.
authors.forename: Adlai
authors.initials: A
authors.lastname: Davids
authors.affiliation: PATH, Seattle, Washington, United States of America.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Lim
authors.affiliation: PATH, Seattle, Washington, United States of America.
authors.forename: Roger
authors.initials: R
authors.lastname: Peck
authors.affiliation: Human Sciences Research Council, Durban, South Africa.
authors.forename: Heidi
authors.initials: H
authors.lastname: van Rooyen
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods*; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D012648:Self Care; D013019:South Africa
references.citation: Lancet. 1997 Feb 1;349(9048):352-3
references.pmid: 9024392
references.citation: N Engl J Med. 2006 Feb 2;354(5):437-40
references.pmid: 16452553
references.citation: AIDS Behav. 2014 Jul;18 Suppl 4:S445-9
references.pmid: 24989129
references.citation: BMC Public Health. 2011 Oct 05;11:766
references.pmid: 21975248
references.citation: Am J Public Health. 2011 Dec;101(12):2325-32
references.pmid: 22021300
references.citation: S Afr Med J. 2010 Oct 01;100(10):636-42
references.pmid: 21081002
references.citation: AIDS Behav. 2014 Jul;18 Suppl 4:S422-32
references.pmid: 24947852
references.citation: Sex Transm Infect. 2003 Dec;79(6):442-7
references.pmid: 14663117
references.citation: Clin Infect Dis. 2013 Jul;57(1):126-38
references.pmid: 23487385
references.citation: AIDS Behav. 2013 Nov;17(9):2946-53
references.pmid: 23142856
references.citation: PLoS One. 2013 Nov 27;8(11):e79772
references.pmid: 24312185
references.citation: AIDS. 2013 Jul 17;27(11):1687-95
references.pmid: 23807269
references.citation: Curr HIV/AIDS Rep. 2009 Nov;6(4):217-23
references.pmid: 19849965
references.citation: BMC Public Health. 2013 Aug 08;13:735
references.pmid: 23924387
references.citation: AIDS Behav. 2014 Jul;18 Suppl 4:S396-404
references.pmid: 24929834
references.citation: Lancet. 2007 Jan 20;369(9557):243-5
references.pmid: 17240291
references.citation: PLoS One. 2010 Aug 26;5(8):e12435
references.pmid: 20865049
references.citation: PLoS Med. 2011 Oct;8(10):e1001102
references.pmid: 21990966
references.citation: AIDS Behav. 2014 Jul;18 Suppl 4:S415-21
references.pmid: 24957979
references.citation: Lancet Infect Dis. 2004 Oct;4(10):640-6
references.pmid: 15451493
references.citation: Trop Med Int Health. 2009 Aug;14(8):849-55
references.pmid: 19552646
references.citation: PLoS One. 2012;7(9):e45168
references.pmid: 23028822