Why HIV self-testing in Africa needs to be more than just another small-scale programme

This month, the Zimbabwean government will move to improve the health conditions of 375,000 of its citizens across 12 districts in the country, by giving the HIV self-testing pilot project, known as Self-Testing in Africa (STAR) a thumbs up. The project, which was launched last year at the 18th International Conference on AIDS and STIs (ICASA) which took place in Zimbabwe, aims at learning how Zimbabweans would react to self-testing for infections and diseases.

According to statistics from Zimbabwe’s Ministry of Health and Child Care, 408,000 out of 1,200,000 people that are presumed to be living with HIV do not know their status. Thus, the self-testing initiative is set to address the public health challenges that exist in Zimbabwe’s health delivery system, significantly.

The HIV self-testing kit comes with written and pictorial instructions in both English and local languages such as Shona and takes about 40 minutes to conduct. STAR is mainly targeted at rural areas in sub-Saharan Africa and will subsequently run in South Africa, Malawi and Zambia with UNITAID as its $23 million sponsor.

Although STAR is currently focused on the aforementioned African countries, sub-Saharan Africa in general which has the highest global population of HIV at 24.7 million people stands to benefit from the self-testing initiative – which intends to spread throughout the continent and the rest of the globe – for a couple of reasons including aiding early detection and treatment, privacy and convenience. And while Africa’s health community welcomes STAR, a number of concerns have been expressed as to its implementation as an adequate health programme.

Initially, the HIV self-testing in Africa was a highly controversial issue, with kits briefly getting banned between 2014 and 2015, and analysts voicing their concerns over how the kit did not make provisions for catering to the mental needs of the individual taking the test in form of counselling. However, the World Health Organisation (WHO) observed that strides have been made in the treatment of HIV following the introduction of self-testing kits to Africa.

Therefore, the organisation suggests that while HIV self-testing HIV is steadily gaining popularity in Africa, particularly among adolescents aged 10 – 19, it must be supported by programmes for awareness, information as well as access to prevention and support. In doing so, the United Nation’s (UN) ‘90-90-90’ target set for the year 2020 can be achieved globally.

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