SaME economists’ role in evaluating HIV self-testing

With an estimated 19 million people living with HIV globally unaware they have the virus, UNITAD is investing $23 million to accelerate access to simple self-tests in three high-burden African countries over the next two years.

With this support, the London School of Hygiene & Tropical Medicine, Population Services International (PSI), the Liverpool School of Tropical Medicine, University College London and the World Health Organization will conduct the world’s largest evaluation of HIV self-testing to date.

Self-testing for HIV is increasingly widely used. Rapid diagnostic kits enable people, particularly those in high-risk groups, to test their own HIV status discretely and conveniently. The initiative plans to deliver 750,000 self-tests during the two-year project in Malawi, Zimbabwe and South Africa, with LSHTM leading the research evaluation components.

The role of SaME economists is to clarify the impact of costing on the uptake of the kits. They will use findings from discrete choice experiments and cost modelling to inform large-scale roll-out in two of the three countries, Malawi and Zambia.

Research by Liz Corbett, Professor of Tropical Epidemiology at LSHTM, with colleagues and partners based in Malawi, has demonstrated that a combination of HIV self-testing and optional home initiation of care resulted in a significant increase in the proportion of adults initiating antiretroviral therapy (ART). More than 13,000 adults took part in the cluster randomized trial, funded by the Wellcome Trust.

Only half of Africans living with HIV are aware of their status, so there is huge need to increase the coverage and frequency of HIV testing, especially for young adults, men and the poorest communities. Self-testing is uniquely enabling, allowing people living in high HIV communities to take control over when and how they want to test and to fit testing in with the rest of their lives. It brings testing right into the household and is the most common choice for preferred ‘next HIV test’ among our participants in Malawi.

Liz Corbett

The new roll-out will:

  • answer key questions about the feasibility, acceptability and impact of this intervention
  • generate crucial information about how to distribute self-test products effectively, ethically and efficiently
  • use these results to support the establishment of appropriate policy
  • encourage new manufacturers to enter the self-test market

At the end of the two years, the self-test markets will be poised to dramatically increase access to HIV testing and impact HIV prevention, care and treatment goals.

UNITAD Press Release: UNITAID invests to identify some of the 19 million HIV undetected

2 comments

  1. calisto munongi

    I am in Zimbabwe. I first had about the introduction of HIV self test kits in a local paper on 7 September 2014. This project is very relevant to my DPhil in Applied Mathematics study with University of South Africa. How can i participate meaningfully in this project. My thesis work is the impact of optimal control on the screening of unaware infectives, condom use and treatment of HIV/AIDS in Southern Africa.

    Reply

    • Michelle Moore

      Dear Calisto,

      Unfortunately, our involvement is only in the economic analysis so we can’t offer any advice. Your DPhil supervisor is the best person to ask, I imagine.

      Best wishes for your studies,

      Michelle Moore

      Reply

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