In this week's PLoS Medicine, Augustine Choko of the Malawi-Liverpool Wellcome Trust Clinical Research Programme, Malawi and colleagues assess the uptake and accuracy of home-based supervised oral HIV self-testing in Malawi, demonstrating the feasibility of this approach in a high-prevalence, low-income setting. Their findings indicate that there is strong community readiness to adopt self-testing alongside other HIV counseling and testing strategies in high HIV prevalence settings in urban Africa.
The authors say: "In settings where regular annual visits to every home by external VCT [voluntary counseling and testing] providers are not feasible, options based on self-testing may offer a more readily sustainable approach that can contribute towards Universal Access goals, provided that mechanisms can be identified to ensure that safety, accuracy, and post-test support are not unduly compromised."
In an accompanying Perspective, Rochelle Walensky and Ingrid Bassett (uninvolved in the study) of Massachusets General Hospital, Boston, USA suggest that linkage to care must be demonstrated before the success of oral HIV self-testing can be determined.
Walensky and Bassett comment: "Beyond making care accessible, the next phase of self-testing feasibility studies must evaluate the completion of the care cascade from testing to treatment to demonstrate true self-testing success."
Article by Augustine Choko and colleagues
Funding: The study was funded by the Wellcome Trust, and sponsored by the London School of Hygiene & Tropical Medicine and hosted by the Malawi-Liverpool Wellcome Trust, Blantyre - Malawi. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Choko AT, Desmond N, Webb EL, Chavula K, Napierala-Mavedzenge S, et al. (2011) The Uptake and Accuracy of Oral Kits for HIV Self-Testing in High HIV Prevalence Setting: A Cross-Sectional Feasibility Study in Blantyre, Malawi. PLoS Med 8(10): e1001102. doi:10.1371/journal.pmed.1001102
CONTACT:
Augustine Choko
Malawi-Liverpool Wellcome Trust Clinical Research Programme
Blantyre
Malawi
+265 999577452
augutc@gmail.com
Perspective by Rochelle Walensky and Ingrid Bassett
Funding: This work was funded by the National Institutes of Mental Health: R01 MH073445, R01 MH65869 and R01 MH090326. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Citation: Walensky RP, Bassett IV (2011) HIV Self-testing and the Missing Linkage. PLoS Med 8(10): e1001101. doi:10.1371/journal.pmed.1001101
CONTACT:
Rochelle Walensky
Division of Infectious Diseases
Massachusetts General Hospital
50 Staniford Street
Boston, MA 2114
United States
rwalensky@partners.org
Journal
PLOS Medicine