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A Systematic Review and Network Meta-analyses to Assess the Effectiveness of Human Immunodeficiency Virus (HIV) Self-testing Distribution Strategies

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Eshun-Wilson, Ingrid, Jamil, Muhammad S, Witzel, T Charles, Glidded, David V, Johnson, Cheryl, Le Trouneau, Noelle, Ford, Nathan, McGee, Kathleen +4 more·2021·Clinical Infectious Diseases
DOI 10.1093/cid/ciab029PMC PMC8366833
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Abstract

Background: We conducted a systematic review and network meta-analysis to identify which human immunodeficiency virus (HIV) self-testing (HIVST) distribution strategies are most effective. Methods: We abstracted data from randomized controlled trials and observational studies published between 4 June 2006 and 4 June 2019. Results: We included 33 studies, yielding 6 HIVST distribution strategies. All distribution strategies increased testing uptake compared to standard testing: in sub-Saharan Africa, partner HIVST distribution ranked highest (78% probability); in North America, Asia, and the Pacific regions, web-based distribution ranked highest (93% probability), and facility based distribution ranked second in all settings. Across HIVST distribution strategies HIV positivity and linkage was similar to standard testing. Conclusions: A range of HIVST distribution strategies are effective in increasing HIV testing. HIVST distribution by sexual partners, web-based distribution, as well as health facility distribution strategies should be considered for implementation to expand the reach of HIV testing services.

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  • Findings are similar to those reported in HIV self-testing studies, which indicated high levels of safety and efficacy across self-testing in different disease areas.

    “Findings are similar to those reported in HIV self-testing studies, which indicated high levels of safety and efficacy across self-testing in different disease areas (76-78).”

    From Updated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (syphilis) and new recommendations on syphilis testing and partner services (2024) · cites this paper as [76]

    The Discussion reports that HIV self-testing distribution strategies increased HIV testing uptake compared with traditional facility-based testing, supporting an effectiveness claim about HIV testing. The cited review does not establish safety or effectiveness across different disease areas; its analysis concerns HIV self-testing. (LLM, conf=0.85)

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Cited by

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Authors
Eshun-Wilson, I., Jamil, M. S., Witzel, T. C., Glidded, D. V., Johnson, C., Le Trouneau, N., Ford, N., McGee, K., Kemp, C., Baral, S., Schwartz, S., & Geng, E. H.
Affiliations
  • Washington University School of Medicine, St Louis, Missouri, USA
  • World Health Organization (CH)
  • London School of Hygiene & Tropical Medicine (GB)
  • University of California, San Francisco (US)
  • Department of Epidemiology, University of California, San Francisco, California, USA
  • Johns Hopkins University (US)
  • Washington University in St. Louis (US)
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2021-01-20
Volume
73
Issue
4
Pages
e1018-e1028
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1093/cid/ciab029
PMC
PMC8366833
OpenAlex
W3122570643
Cited by
81
References
1
Citations by year
2026: 10 · 2025: 11 · 2024: 17 · 2023: 15 · 2022: 22 · 2021: 6
FWCI
1.76
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Infectious Diseases (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
  • Digital Commons@Becker (Washington University School of Medicine) (submittedVersion, cc-by)
Funders
  • National Institutes of Health (K24 AI134413)
  • Bill and Melinda Gates Foundation (OPP1215984)
  • National Institute for Health Research (PG-1212–20006)
Topics
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
  • Social Sciences › Business, Management and Accounting › Management of Technology and Innovation › Blood donation and transfusion practices
Keywords
HIV self-testing, HIV testing uptake, facility-based HIV testing, linkage to care, HIV seropositivity, HIV testing services
MeSH terms
Network Meta-Analysis, Self-Testing, HIV, Humans, Mass Screening, Sexual Partners, HIV Infections

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