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

Ingrid Eshun-Wilson, Muhammad S. Jamil, T. Charles Witzel, David V. Glidded, Cheryl Johnson, Noelle Le Trouneau, Nathan Ford, Kathleen McGee, Chris Kemp, Stefan Baral, Sheree Schwartz, Elvin H. Geng

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

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.

Original languageEnglish
Pages (from-to)E1018-E1028
JournalClinical Infectious Diseases
Volume73
Issue number4
DOIs
StatePublished - Aug 15 2021

Keywords

  • HIV self-testing
  • implementation
  • network meta-analysis
  • systematic review

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