Examining the Use of HIV Self-Testing to Support PrEP Delivery: a Systematic Literature Review

Curr HIV/AIDS Rep. 2022 Oct;19(5):394-408. doi: 10.1007/s11904-022-00617-x. Epub 2022 Jul 29.

Abstract

Purpose of review: HIV self-testing (HIVST) has the potential to expand access to and uptake of HIV pre-exposure prophylaxis (PrEP) delivery. We conducted a systematic literature review to understand the evidence on HIVST use for PrEP delivery.

Recent findings: After screening 1055 records, we included eight: three randomized trials and five values and preferences studies. None measured PrEP initiation. Most studies occurred in Sub-Saharan Africa (7/8) and included different populations. One trial found that HIVST use between quarterly clinic visits as part of an adherence package with biofeedback slightly increased adherence; the other two trials found that HIVST use between or in lieu of quarterly clinic visits had no significant or non-inferior effects on adherence. HIVST to support PrEP delivery was acceptable, feasible, and preferred. HIVST use for PrEP continuation largely resulted in similar outcomes to standard-of-care delivery and was perceived acceptable and feasible. Further research is needed to optimize HIVST use within PrEP programming.

Keywords: HIV prevention; HIV self-testing; Implementation science; PrEP delivery; Sub-Saharan Africa; Systematic literature review.

Publication types

  • Review
  • Systematic Review
  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • HIV Infections* / diagnosis
  • HIV Infections* / prevention & control
  • HIV Testing
  • Humans
  • Mass Screening / methods
  • Pre-Exposure Prophylaxis* / methods
  • Self-Testing