4 June 2018

Tanzania: HIV Self-Testing Is Here, Where Are Supportive Systems?

Finally, the HIV self-testing issue went to parliament last week, and the Health Minister, Ummy Mwalimu was at it--addressing MPs on why the law needs to change to accommodate self-testing in the privacy of people's homes, offices and so on.

We were used to the conventional methods; where one has to go to a health facility but now, there is a lot of talking on self-testing.

Just like many other things in the health sector, laws must change to cope with the rapidly advancing technology, but one important thing is: Our mindset must change too.

Changing the mindset doesn't come overnight. Already, many people are asking many questions about the government's plan to introduce HIV self-testing.

Dann*, from Ukonga, heard it on radio and his argument was: "I see a possibility that people might abuse this test. What if a partner forces another to test?," he pointed out.

Others, such as Dann, have come out to say that self-testing might encourage people to practise more unsafe sex. This, they say, might lead to other sexually transmitted infections and unplanned pregnancies.

As the government mulls putting in place the relevant legal frameworks, there is also the need to come up with well-researched mechanisms to help people know how to go about self-testing.

As medics, we are already seeing exciting opportunities for individuals to make choices about how and when to take a HIV test as well as the frequency of testing, when this comes into force.

We have seen this in other public health interventions. Families and individuals are making choices about family size. Why not HIV-self testing?

If the government rolls this HIV-testing thing out, the burden will be reduced for healthcare workers who are already constrained by many tasks at various testing centers and health facilities.

Queues. This has been a problem and some people have complained about the lack of privacy. If the self-testing programme starts, it means that it will no longer be necessary to queue at a Voluntary Counselling and Testing (VCT) centres.

This might save time for other social and economic responsibilities.

One key point still, is about men. Last week, Prime Minister Kassim Majaliwa noted, with concern that men have been holding back the country's efforts to ensure every Tanzanian goes for an HIV test.

As he announced plans for a national campaign on HIV-testing, the PM called on men to wake up and know their status.

In addition to the PM's impetus, this self-testing plan comes at the right time for men who seldom visit health facilities.

But, above all, the health system has to be supportive. It shouldn't be problematic for people to get confirmatory tests.

Let's invest in biometrics, phone applications, call centres and a centralized database.

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