title: Potential public health benefits of HIV testing occurring at home in Australia.
abstract: In many countries, including Australia, policies have recently changed to support HIV self-testing. The decision has created much debate about the public health benefits of the strategy versus the risks. Self-testing for HIV was approved in the US on the basis that it would facilitate greater HIV testing uptake, despite having a lower sensitivity than laboratory HIV immunoassays. We calculated the frequency of self-testing that would be required among Australian gay and bisexual men at high-risk for there to be a public health benefit (detection of HIV infections that would have otherwise remained undiagnosed). At a population level, if access to HIV self-testing led to men supplementing their usual sexual health check-ups (involving a laboratory HIV immunoassay) with one or more self-tests at home, or self-tests led to untested gay and bisexual men having an HIV test for the first time, there would be a public health benefit. If men replaced their average of one laboratory HIV immunoassay per year with self-testing at home, then three self-tests would be needed to counteract the lower sensitivity of the self-test (so zero infections would be missed). If four self-tests were undertaken then additional infections would be detected (ie, there would be a public health benefit). Additional public health benefits include a reduction in the period of undiagnosed infection, which is known to be a period of relatively high infectiousness.
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Guy
authors.forename: Garrett P
authors.initials: GP
authors.lastname: Prestage
authors.forename: Andrew
authors.initials: A
authors.lastname: Grulich
authors.forename: Martin
authors.initials: M
authors.lastname: Holt
authors.forename: Damian P
authors.initials: DP
authors.lastname: Conway
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Jamil
authors.forename: Phillip
authors.initials: P
authors.lastname: Keen
authors.forename: Philip
authors.initials: P
authors.lastname: Cunningham
authors.forename: David P
authors.initials: DP
authors.lastname: Wilson
mesh_terms: D001315:Australia; D042241:Early Diagnosis; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D011634:Public Health; D012648:Self Care; D012680:Sensitivity and Specificity