(HealthDay News) – Self-testing for HIV, either supervised or unsupervised, is highly accepted and preferred over facility-based testing, according to a review published online April 2 in PLoS Medicine.

Nitika Pant Pai, MD, MPH, PhD, from McGill University in Montreal, Canada, and colleagues reviewed 21 studies examining HIV self-testing strategies for acceptability, feasibility, accuracy, and success with linkages to care.

The researchers found that self-testing could be either supervised (self-testing and counseling aided by a health-care professional; seven studies) or unsupervised (self-testing performed without any help but with counseling available by phone or internet; 14 studies). Data on acceptability, preference, and partner self-testing were high for both strategies; self-testing was preferred to facility-based testing and oral self-testing to blood-based self-testing. Lower sensitivity was seen in unsupervised (92.9–100%) vs. supervised (97.4–97.9%) self-testing, while high specificity was noted in both strategies (range 99.8–100%). In one study, 96% of individuals testing positive reported that they would seek post-test counseling.

“Although self-testing offers the potential to increase the number of individuals to self-screen for HIV and therefore deliver more people to care, systems that can maintain confidentiality and operationalize linkage to care within a reasonable time frame are pertinent to its success,” Pai and colleagues conclude. “More data from diverse settings are needed to inform global scale-up and policy recommendations for HIV self tests.”

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