1LARGE-SCALE INTRODUCTION OF RAPID HIV SELF-TESTS

Unitaid is working to provide Africa with a self-testing kit that costs only US$ 2, compared to US$ 50 in the US. The price reduction will help make a diagnosis possible for the estimated 14.5 million people living with HIV who do not know they are infected.

The results of the world’s largest HIV self-test evaluation, funded by Unitaid in Malawi, Zambia and Zimbabwe, show that HIV self-tests can reach those who have never been tested for HIV. New WHO guidelines recommend the use of HIV self-testing to help get people diagnosed and put on treatment. The Bill & Melinda Gates Foundation supported the price negotiation.

Unitaid’s self-testing portfolio is quickly evolving. Projects focused on self-testing in francophone Africa are in development for 2018 with Solthis and MTV’s Staying Alive Foundation.

Unitaid is investing US$ 72.2 million to evaluate the benefits of HIV self-testing in resource-limited settings, and to develop a market for HIV self-testing. The HIV Self-Testing Africa (STAR) project was implemented in 2015 in three African countries by our partner Population Services International (PSI) and expanded to three more countries in the summer of 2017. STAR promotes user-friendly tests to increase the number of people who know their HIV status, and to ensure they have access to treatment and prevention services. The kits allow people to test themselves using an oral swab or a pinprick and provide results in minutes. By demonstrating demand for HIV self-testing, the project also seeks to influence national and global policies. The STAR project accounts for more than 90 percent of all self-tests currently distributed in Africa. The Bill & Melinda Gates Foundation launched a collaboration with OraSure in June 2017, reducing the price of their HIV self-testing product, OraQuick, in 50 countries and making the product more accessible. The agreement offers security of supply at affordable rates and will reinforce scale-up of the STAR project.

“We have evidence now that demand and acceptability of HIV self-test kit use is high when offered in communities and at health facilities. We are reaching people who would otherwise not access HIV testing services.” Dr. Karin Hatzold STAR Project Director, PSI

Self-testing has the potential to turn the course of the epidemic by increasing the number of people who know their HIV status. Self-testing can strengthen HIV diagnostics in resource-limited settings and can help get more HIV-positive people into treatment. Those who test negative can be referred to other prevention services, such as voluntary medical male circumcision (VMMC) or pre-exposure prophylaxis (PrEP).