About this Research Topic
According to the most recent data from the Joint United Nations Program on HIV/AIDS (UNAIDS), new HIV infections fell by 39% between 2000 and 2019. HIV-related deaths fell by 51% over the same time period, and some 15 million lives were saved through the use of antiretroviral therapy. However, progress towards global targets is stalling. Over the last two years, the annual number of new HIV infections has plateaued at 1.7 million and there was only a modest reduction in HIV-related death, from 730 000 in 2018 to 690 000 in 2019. Despite steady advances in scaling up treatment coverage – with more than 25 million people in need of ARVs receiving them in 2019 – key 2020 global targets will be missed. HIV prevention and testing services are not reaching the groups that need them most. Improved targeting of proven testing approaches will be critical to reinvigorate the global response to HIV.
Although the absolute number of people who have tested for HIV and know their HIV status has improved over the years in sub-Saharan Africa, there are still large pockets of unreached populations who continue to contribute to the high number of new HIV infections. These populations include: adolescents and young people (10-24 years), adult men, gay and bisexual men who have sex with men, female sex workers and their sexual partners; refugees, migrants and other mobile populations (including truck drivers and their assistants and the fisher-folk) and HIV sero-discordant couples. Without accelerated access to HIV testing services, these populations will remain unaware of their HIV status, and continue to spread HIV to their sexual partners and unborn babies unabated. In order to end the epidemic by 2030, there is a need for innovative HIV testing approaches, including approaches that can reach people where they are: outside of formal health facility settings. Evidence from multi-country studies conducted in Eastern and Southern Africa confirms that HIV self-testing is highly feasible and acceptable and can reach populations that have been missed through conventional HIV testing services. However, little evidence exists on what models of HIV self-testing delivery are the most feasible and cost-effective to reach these populations and there are still challenges regarding what approaches are the best in improving linkage to HIV care among HIV-positive self-tested individuals living in hard-to-reach communities, far away from healthcare services.
In this Research Topic, we aim to publish papers that describe innovative models of HIV self-testing and their impact on uptake of HIV testing services among missing populations. We also aim to investigate models for improving confirmatory HIV testing and linkage to HIV care among confirmed HIV-positive individuals; costing and cost-effectiveness of innovative HIV self-testing models, and papers describing research utilization of HIV self-testing data to inform the development of policies and programs. Our aim is to publish Original Research papers and Systematic Reviews and meta-analyses on any of the following thematic areas:
• Innovative HIV self-testing delivery models (community-based/community-led/peer-led distribution; social network-based distribution; distribution of HIV self-test kits through the workplaces, pharmacies/drug shops, internet, etc.) and their impact in reaching the missing populations in the HIV response
• Use of innovative HIV self-testing diagnostics, including the use of urine and blood for HIV self-testing
• Approaches for improving uptake of confirmatory HIV testing among self-testing individuals
• Linkage to HIV care following HIV self-testing in hard-to-reach populations with limited access to health facilities
• Effect of COVID-19 on uptake of HIV self-testing services
• Qualitative studies on the motivations for and barriers to linkage to HIV care following a positive HIV self-test result
• Impact evaluation of HIV self-testing models
• From research to policy: scaling-up HIV self-testing at national level
• Costing and cost-effectiveness of HIVST delivery models
• Studies comparing the efficacy of HIV self-testing with and without assisted partner notification in improving HIV testing uptake and linkage to HIV care among index partners of HIV-positive individuals enrolled in HIV care
• Point-of-care HIV self-testing
Keywords: HIV, HIV self-testing, Missing populations, Sub-Saharan Africa
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