Technology IconTechnology: HIV self-testing

OBJECTIVES

To improve access to the full range of evidence-based HIV testing technologies for people at risk of HIV across Australia.


CURRENT ISSUES

  • Knowledge of status builds the capacity of individuals to, in the event of a negative result, minimise the risk of HIV acquisition or, in the event of a positive result, be linked to care to discuss treatment options and better understand the risks of onward transmission;
  • Frequent, easy testing and early diagnosis are critical if Australia is to reach its target of virtually eliminating HIV transmission in Australia;
  • HIV self-testing is identified in the National HIV Strategy as a tool that can simplify the testing process and address access and acceptability issues such as cost, time and convenience;
  • HIV self-testing has been endorsed by the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine’s updated National HIV Testing Policy (February 2017);
  • The Kirby’s Institute’s Frequency of Oral Rapid Testing at Home (FORTH) study has concluded that “HIV self-testing resulted in a two-times increase in frequency of testing in gay and bisexual men at high risk of infection, and a nearly four times increase in non-recent testers, compared with standard of care, without reducing the frequency of facility- based HIV testing”;
  • At present, HIV self-tests can be lawfully purchased online for personal use. However, as the TGA is yet to approve HIV self-tests for use in Australia, the quality and sensitivity of devices purchased online has not been assessed against Australian standards.

PROPOSED ACTIVITIES

  • That the Australian Government adopt an active posture on improving access to high quality HIV self-tests, through:
    • monitoring the environment for suitable candidates; , supporting the approval of HIV self-tests for purchase online;
    • supporting a regulatory environment and regulatory process which provides individuals with access to high quality self-tests; and
    • investing in the development of educational materials (such as online instructional videos) to guide use and interpretation of the device and to identify appropriate pathways to care in the event of an HIV positive result.
  • Use self-testing as a pathway to educate individuals about HIV prevention, and the bene ts of care for people newly diagnosed with HIV.
  • Support any future recommendation from the Medical Services Advisory Committee (MSAC) to publicly fund accessibility to HIV self-testing devices for key HIV populations and individuals at high-risk of HIV.

IMPACT

Increase the frequency of testing, including among non-recent testers, to facilitate earlier diagnosis of HIV acquisition and earlier engagement in care

COST-BENEFIT

  • Reducing the time between seroconversion, diagnosis and treatment will improve individual health outcomes and reduce the risk of onward HIV transmission;
  • More frequent testing has the potential to increase awareness and engagement with HIV prevention tools if self-tests are accompanied by appropriate prevention materials.

ADDITIONAL INVESTMENT

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