Strategies for implementing HIV self-testing in diverse populations: an integrative review

OBJECTIVES: to identify strategies for implementing HIV self-testing in populations. METHODS: an integrative review of MEDLINE/PubMed, Scopus, CINAHL, Web of Science, and LILACS databases. Full articles available online, in Portuguese, English, Spanish, or French, regardless of the year of publication, were included. Letters to the editor, review articles, and duplicates, rapid tests performed by professionals, and home self-tests sent to a laboratory without on-site results, were excluded. The sample of 24 articles had their level of evidence assessed using descriptive data analysis. RESULTS: the most prevalent strategy for implementing self-testing was community distribution through home visits, mail, and distribution points such as bars, nightclubs, and transportation terminals. Peer distribution was significant among men who have sex with men, young people, and trans women, with primary delivery directly to the individual or secondary delivery, where one individual delivers to others. Social and technological media facilitated patient recruitment, delivery, and connection to healthcare services. CONCLUSIONS: the distribution of HIV self-tests in the community was the most accessible strategy, which increased the use of combination HIV prevention methods and initiation of antiretroviral therapy. The main challenges to implementing self-testing were financial costs and acceptance, due to fear of results, stigma, and intimate partner violence

• Epidemiology and Determinants of Health
  • Determinants of Health
• Determinants of Health
  • Employment
  • Income
  • Education
  • Social support
  • Health services
  • Stigma/discrimination
  • Abuse
  • Other
• Population(s)
  • Men who have sex with men
  • Women
  • Children or Youth (less than 18 years old)
  • Transgender communities
  • Sex workers
  • General HIV- population
• Prevention, Engagement and Care Cascade
  • Prevention
• Prevention
  • Sexual risk behaviour
  • Biomedical interventions
  • Education/media campaigns
• Testing
  • Testing
• Health Systems
  • Governance arrangements
  • Financial arrangements
  • Delivery arrangements