Expanding HIV self-testing in Africa

Lesotho, South Africa and Eswatini join the second phase of the Self Testing Africa initiative.


Only an estimated 70 percent of people living with HIV know their status; many live far from clinics and/or are reluctant to seek testing because of the stigma associated with HIV in some communities.


Innovative approaches to diagnosis, such as self-testing, can help reach undiagnosed people who are living with HIV, and meet global goals on ending the epidemic.

Progress so far

Acheivements of phase 1-3 STAR is a Unitaid-funded initiative to catalyze the global market for HIVST, generate evidence for decision-making and create an enabling environment for HIVST scale-up.

STAR PHASE 1 involved evaluation of products and delivery models in Malawi, Zambia and Zimbabwe.

STAR PHASE 2 built on the evidence and experience generated in the first phase to scale up access to HIVST across sub-Saharan Africa and expanded to three additional countries (South Africa, Lesotho and Eswatini) and laid the groundwork for rapid country-level HIVST scale-up.

STAR PHASE 3 involves a further seven markets: Cameroon, Mozambique, Nigeria, Tanzania and Uganda in Africa; and India and Indonesia in Asia, where STAR is creating an enabling environment for HIVST scale-up and advocate for further donor investment. It is focused on addressing market barriers to HIVST roll out and establishing the structures, systems and oversight mechanisms necessary for long-term sustainability, using knowledge derived from the first two phases of STAR. The project has also layed the foundations for further investments in Covid-19 self-testing and HCV self-testing. So far, 4.8 million test kits have been distributed; 102 countries have HIV self-test policies; 38 contries are actively implementin self-testing: 13 countries national governments are actively supported by STAR; and 6 HIV self-test kits are pre-qualified by the WHO.

“The brilliance of the Unitaid-funded STAR Initiative has been to take a recognized technology and find ways to get it into the hands of those we most need to reach if we are to control the HIV epidemic: men, highly stigmatized groups and those who have been left out of years of investment in HIV testing.”

Karl Hofmann, president and CEO, PSI

The impact we are seeking

Self-testing has the potential to turn the course of the HIV/AIDS epidemic by increasing the number of people who know their HIV status.  The STAR initiative plans to distribute 4.7 million test kits.

People who discover that they are infected can be linked to antiretroviral treatment that keeps them healthy and prevents the infection from being transmitted to others. Self-testing also creates an avenue to healthcare for people who discover they are not infected; they may still feel they are at high risk for HIV, and through the self-testing program find other prevention services, such as voluntary medical male circumcision or pre-exposure prophylaxis (PrEP)–taking antiretroviral drugs to block HIV.

Population Services International is implementing the project in Lesotho, Swaziland, Malawi, Zambia and Zimbabwe. Society for Family Health is leading the South Africa portion.

Grantee's project page

Grantee’s project page, click here

Video: STAR Self-Testing: Breaking Barriers for the Elimination of Hepatitis C Globally

Video: HIV Self-Testing towards Universal Health Coverage, Unitaid’s Investments in HIV Self-Testing

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