Strategies for implementing HIV self-testing in diverse populations: an integrative review.
Maiara Bezerra Dantas, Gilmara Holanda da Cunha, Régia Christina Moura Barbosa Castro and 3 others
PMID 41417329WHAT IT FOUND
HIV self-test distribution reached people mainly through community and peer routes, but no single method was enough.
Counseling, privacy, and clear instructions mattered, and positive tests did not always lead to treatment.
Key findings
01Community distribution and peer distribution were the most common ways HIV self-tests reached people.
02Privacy, convenience, counseling, and clear instructions were reported as important for acceptability, and lack of counseling was reported as a barrier.
03Self-testing was reported to increase access to confirmatory testing and prevention services, but several distribution studies did not show increased ART initiation or adherence.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review could not combine studies in a meta-analysis, and the evidence base was uneven: 12 were descriptive or qualitative, 3 were cohort or case-control, 1 was a non-randomized clinical trial, and 8 were at randomized-trial evidence level. The search used a limited set of descriptors, so some relevant studies may have been missed. No study addressed safe disposal of used HIV self-tests, which are potentially contaminated. The review describes distribution strategies and experiences, not a tested clinical outcome for one patient.
The easy way to misread this
Do not conclude that community or peer distribution alone is proven to increase treatment uptake. The review found mixed effects, and several distribution studies did not show increased ART initiation or adherence.