HIV testing for all

HIV self-testing in Peru: questionable availability, high acceptability but potential low linkage to care among men who have sex with men and transgender women.

Bustamante MJ, Konda KA, Joseph Davey D, Leon SR, Calvo GM, Salvatierra J, Brown B, Caceres CF, Klausner JD. Int J STD AIDS. 2017 Feb;28(2):133-137. doi: 10.1177/0956462416630674. Epub 2016 Jul 10.

HIV status awareness is key to prevention, linkage-to-care and treatment. Our study evaluated the accessibility and potential willingness of HIV self-testing among men who have sex with men (MSM) and transgender women in Peru. We surveyed four pharmacy chains in Peru to ascertain the commercial availability of the oral HIV self-test. The pharmacies surveyed confirmed that HIV self-test kits were available; however, those available were not intended for individual use, but for clinician use. We interviewed 147 MSM and 45 transgender women; nearly all (82%) reported willingness to perform the oral HIV self-test. However, only 55% of participants would definitely seek a confirmatory test in a clinic after an HIV-positive test result. Further, price may be a barrier, as HIV self-test kits were available for 18 USD, and MSM and transgender women were only willing to pay an average of 5 USD. HIV self-testing may facilitate increased access to HIV testing among some MSM/transgender women in Peru. However, price may prevent use, and poor uptake of confirmatory testing may limit linkage to HIV treatment and care.

Abstract access   [1]

Editor’s notes: One of the key ways to reduce stigma around HIV is to increase uptake of HIV testing, making it more acceptable and widely available. The authors of this paper sought to understand the barriers to the use of oral self-testing HIV kits. Evidence illustrates that awareness of HIV status leads to safer sexual and injecting risk behaviours and reduced HIV prevalence. Gay men and other men who have sex with men and transgender women are often marginalized populations. They can experience increased prevalence of HIV and have poorer access to HIV testing and treatment. This descriptive study provides important information illustrating that the use of oral self-testing HIV kits are acceptable to gay men and other men who have sex with men and transgender women. On average, respondents said they would undergo testing four times a year. While test kits were available at pharmacies, the higher price prohibits frequent use. Following diagnosis with a self-test, two thirds of transgender women and 71% of gay men and other men who have sex with men said they would follow up with a confirmatory test. Strategies are necessary to encourage everyone to access services to receive confirmatory testing, counselling and referral to treatment and care as necessary. Prices of HIV self-testing kits need to be lowered to increase accessibility.

HIV testing and treatment [3]
Latin America [4]
Peru [5]
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