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REVIEW (Open Access)
Contents Vol 21(4)

A typology of HIV self-testing support systems: a scoping review

Arron Tran https://orcid.org/0009-0007-2800-0941 A B , Nghiep Tran A , James Tapa B , Warittha Tieosapjaroen https://orcid.org/0000-0001-9712-9262 B C , Christopher K. Fairley https://orcid.org/0000-0001-9081-1664 B C , Eric P. F. Chow https://orcid.org/0000-0003-1766-0657 B C D , Lei Zhang https://orcid.org/0000-0003-2343-084X B C , Rachel C. Baggaley E , Cheryl C. Johnson E , Muhammad S. Jamil F and Jason J. Ong https://orcid.org/0000-0001-5784-7403 B C F *
+ Author Affiliations
- Author Affiliations

A Melbourne Medical School, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Vic, Australia.

B Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic, Australia.

C Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic, Australia.

D Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic, Australia.

E Global HIV, Hepatitis and STI Programmes, World Health Organization, Geneva, Switzerland.

F Department of Communicable Diseases, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt.

G Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.

* Correspondence to: Jason.ong@monash.edu

Handling Editor: Michael Marks

Sexual Health 21, SH24037 https://doi.org/10.1071/SH24037
Submitted: 14 February 2024  Accepted: 4 June 2024  Published: 1 July 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

To maximise the benefits of HIV self-testing (HIVST), it is critical to support self-testers in the testing process and ensure that they access appropriate prevention and care. To summarise systems and tools supporting HIVST (hereafter, ‘support systems’) and categorise them for future analysis, we synthesised the global data on HIVST support systems and proposed a typology. We searched five databases for articles reporting on one or more HIVST support systems and included 314 publications from 224 studies. Across 189 studies, there were 539 reports of systems supporting HIVST use; while across 115 studies, there were 171 reports of systems supporting result interpretation. Most commonly, these were pictorial instructions, followed by in-person demonstrations and in-person assistance while self-testing or reading self-test results. Less commonly, virtual interventions were also identified, including online video conferencing and smartphone apps. Smartphone-based automated result readers have been used in the USA, China, and South Africa. Across 173 studies, there were 987 reports of systems supporting post-test linkage to care; most commonly, these were in-person referrals/counselling, written referrals, and phone helplines. In the USA, Bluetooth beacons have been trialled to monitor self-test use and facilitate follow-up. We found that, globally, HIVST support systems use a range of methods, including static media, virtual tools, and in-person engagement. In-person and printed approaches were more common than virtual tools. Other considerations, such as linguistic and cultural appropriateness, may also be important in the development of effective HIVST programs.

Keywords: HIV screening, HIV/AIDS, linkage to care, result interpretation, self-testing, support system, typology, virtual.

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