Rwanda: HIV Self-Test Services Key to End the Epidemic

Rwandan and Mozambican presidents Paul Kagame and Filipe Nyusi, First Lady Jeannette Kagame and her counterparts from around the continent, as well as other high-profile delegates in a group photo after the opening of the ICASA 2019 conference in Kigali.
2 December 2019

Increasing the ability for people to test themselves for HIV could bolster efforts to universal access to treatment, according to Heather Watts Director of HIV Prevention, Office of the Global AIDS Coordinator.

Under its fast-track target known as 90-90-90, by 2020 UNAIDS aims to have 90 percent of people with HIV knowing they are HIV-positive, 90 per cent of diagnosed people on treatment, and 90 per cent of those on treatment able to use the medication to suppress the amount of virus in their bodies to a low level.

“We see self-testing as a game-changer that really is going to be crucial in meeting our 90-90-90 and the 95-95-95 goals, and especially for the populations that we haven’t been reaching so far,” Watts said on Monday during a session at the ongoing International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA).

In many of our countries, she stated, it is still so difficult for key populations to access testing services.

"I think self-testing is a really key option, where they could either get their selves tested from either community workers, or social network testing, or from private pharmacies,

“We know that probably over half of the continuing epidemic is contributed by key population’s transmission and that’s again because of the stigma and discrimination, that we can help to address with self-testing”, she added.

While HIV self-testing services have gained popularity in some countries, the world is still looking for ways to expedite its acceptance, especially among populations with low access and those at higher risk that would otherwise not get tested, for instance, the key population.

The key population— people who inject themselves with drugs, the gay community, transgender persons, sex workers and prisoners—are the most susceptible to HIV/AIDS infection.

According to UNAIDS data, key populations and their sexual partners account for 54 per cent of new HIV infections globally, with 95 per cent of new HIV infections in Middle East and North Africa, 64 per cent new HIV infections in Western and Central Africa and 25 per cent of new HIV infections in Eastern and Southern Africa.

This is mainly because the risk of acquiring HIV is 22 times higher among men who have sex with men and among people who inject drugs, 21 times higher for sex workers and 12 times higher for transgender people.

Whereas 77 countries have adopted HIV self-testing policies, 21 per cent of all people with HIV remain unaware of their condition.

More about HIV self-testing services

HIV self-testing is where a person collects his or her own specimen (oral fluid or blood) and then performs an HIV test and interprets the result, often in a private setting, either alone or with someone he or she trusts.

Self-testing is often done with an HIV Rapid Test, an HIV antibody test used to screen for HIV infection.

It can detect HIV antibodies in blood or oral fluid in less than 30 minutes.

Some of the challenges holding back the adopting of self-testing services in Africa include the high cost of the Rapid Tests and linkage-where some people don’t report that the test was positive, for a confirmatory test.

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