Expanding Access to HIV Self-Testing: A Market Development Approach

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Abstract

In 2014, an estimated 36.7 million people were living with HIV globally. The Joint United Nations Program on HIV/AIDS estimates that globally 60% of people living with (PLHIV) know their status. In 2014, the United Nations launched the ambitious “90-90-90” targets to accelerate progress to end the HIV/AIDS epidemic. These goals call on the global community to ensure that by 2020, 90% of PLHIV are diagnosed, 90% of those diagnosed are linked to antiretroviral treatment (ART), and 90% of people on ART to achieve viral suppression2. While the scale-up of testing and treatment has been significant, a substantial testing gap remains with 40% of all people living with HIV remaining undiagnosed globally. Closing this testing gap through increased coverage and the scaling-up of approaches that can reach individuals with undiagnosed HIV and at high ongoing HIV risk will be critical to achieve the first 90.

HIV self-testing (HIVST) is a new approach that has significant potential to extend access to HIV testing beyond the limitations of the current infrastructure and address barriers to testing. HIVST may be offered through a diversity of existing and new channels, including health facilities, community-based programs and pharmacies. HIVST delivered in these channels may provide directly assisted or unassisted HIV self-testing.