A systematic review and network meta-analyses to assess the effectiveness of HIV self-testing distribution strategies


BACKGROUND: We conducted a systematic review and network meta-analysis to identify which HIV self-testing (HIVST) distribution strategies are most effective. METHODS: We abstracted data from randomized controlled trials and observational studies published between June 4, 2006 and June 4, 2019. RESULTS: We included 33 studies, yielding six HIVST distribution strategies. All distribution strategies increased testing uptake compared to standard testing: in sub-Saharan Africa, partner HIVST distribution ranked highest (78% probability); in North America, Asia and the Pacific regions, web-based distribution ranked highest (93% probability), and facility based distribution ranked second in all settings. Across HIVST distribution strategies HIV positivity and linkage was similar to standard testing. CONCLUSION: A range of HIVST distribution strategies are effective in increasing HIV testing. HIVST distribution by sexual partners, web-based distribution, as well as health facility distribution strategies should be considered for implementation to expand the reach of HIV testing services.


Eshun-Wilson I, Jamil MS, Charles T, Glidden DV, Cheryl J, Noelle T, Ford N, McGee K, Chris K, Stefan B, Schwartz S, Elvin GH




  • Population(s)
    • Men who have sex with men
    • Transgender communities
    • People who use drugs
    • General HIV- population
  • Testing
    • Testing
  • Health Systems
    • Delivery arrangements


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