Use of self-test to increase HIV testing among men who have sex with men and transgender women—Overview of systematic reviews

ABSTRACT Human Immunodeficiency Virus (HIV) infection is stigmatizing, especially for key populations, who are disproportionately affected by Sexually Transmitted Infections (STIs). The stigma and discrimination suffered by these groups are among the main obstacles to HIV prevention, treatment and care, which is why the World Health Organization recommends the use of self-tests to increase HIV testing and achieve the 95-95-95 target by 2030 proposed by the United Nations. We conducted an overview of systematic reviews and meta-analyses, searching for free and indexed terms in nine databases, and using the acronym PICO as an inclusion criterion. Two independent reviewers performed the selection in two stages, and disagreements were resolved by consensus with a third reviewer. Quality analysis was performed using the Assessing the Methodological Quality of Systematic Reviews, version 2 (AMSTAR 2) tool. Four studies were included, one evaluating men who have sex with men (MSM), one evaluating MSM and another key population, and two evaluating MSM and transgender women (TGW). HIVST was effective in increasing testing frequency and uptake and was considered as good as or better in detecting new HIV infections. However, the presence of more than one critical weakness and multiple non-critical flaws reduced the overall confidence.

• Epidemiology and Determinants of Health
  • Determinants of Health
• Determinants of Health
  • Stigma/discrimination
• Population(s)
  • Men who have sex with men
  • Transgender communities
  • General HIV- population
• Testing
  • Testing
• Health Systems
  • Delivery arrangements