Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Mar;25(3):e25897.
doi: 10.1002/jia2.25897.

Towards the first 90: impact of the national HIV self-test program on case finding and factors associated with linkage to confirmatory diagnosis in Taiwan

Yen-Fang Huang  1   2 , Yu-Ching Huang  1 , Yi-Chun Lo  1 , Carl Latkin  3 , Hsun-Yin Huang  1 , Chia-Chi Lee  1 , Li-Chern Pan  4 , Hsu-Sung Kuo  1
Affiliations

Towards the first 90: impact of the national HIV self-test program on case finding and factors associated with linkage to confirmatory diagnosis in Taiwan

Yen-Fang Huang et al. J Int AIDS Soc. 2022 Mar.

Abstract

Introduction: Being aware of one's HIV-positive status can help reduce unprotected sex and promote early treatment seeking. Therefore, HIV self-test (HIVST) programs may help control the HIV epidemic by case finding. The aims of this study were to determine the effect of HIVST programs on HIV case finding, time to confirmatory diagnosis and factors associated with linkage to confirmatory diagnosis in Taiwan.

Methods: The Centers for Disease Control in Taiwan initiated HIVST programs and imported 78,000 self-test kits in 2017 and 2019. Clients paid 7 US dollars for a self-test kit at facilities, vending machines or online. The programs set up an HIVST logistics management system; each kit had a unique barcode for monitoring the programs because purchases were anonymous. When clients provided their test results with photo barcodes online or at HIV/AIDS-designated hospitals, they received full monetary reimbursement. We conducted a quasi-experimental interrupted time-series (ITS) analysis that covered a period of 60 months from 2015 to 2019. We enrolled a retrospective cohort of reported HIV cases with initial positive results from HIVST programs between March 2017 and July 2020.

Results: The ITS analysis included data from 10,976 reported HIV cases from 2015 to 2019. The HIVST-positive cohort included 386 reported HIV cases, of whom 99.7% were males and 97% were men who have sex with men (MSM); the median age was 28 years. The ITS analysis showed a positive slope change in the number of reported HIV cases immediately in the beginning implementation month (coefficient: 51.09 in 2017 and 3.62 in 2019), but there was a significant decrease over time. It was a negative slope change by 9.52 cases per month in 2017 and 5.56 cases per month in 2019. In the HIVST-positive cohort, three of five individuals linked to HIV confirmatory diagnosis within 1 month after a positive self-test result, and an early linkage to confirmatory diagnosis was associated with HIVST disclosure (adjusted OR = 6.5; 95% CI: 3.9-10.6).

Conclusions: HIVST programs were associated with an increase in HIV case finding. Our findings suggest that countries with a high incidence of HIV among MSM populations should offer multichannel HIVST services.

Keywords: HIV epidemiology; HIV self-test; HIV testing; intervention; men who have sex with men; public health.

PubMed Disclaimer

Conflict of interest statement

The authors have no competing interests.

Figures

Figure 1
Figure 1
Study sample recruitment process. Abbreviations: F, facilities; O, online; U, HIVST disclosure to health workers but without barcodes (unknown purchasing channels); V, vending machines.
Figure 2
Figure 2
The impact of the HIVST programs on the case finding curve according to ITS analysis.
Figure 3
Figure 3
Time to HIV confirmatory diagnosis.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. WHO . WHO recommends HIV self‐testing: evidence update and considerations for success: policy brief. Geneva: World Health Organization; 2019.
    1. Macpherson P, Lalloo DG, Webb EL, Maheswaran H, Choko AT, Makombe SD, et al. Effect of optional home initiation of HIV care following HIV self‐testing on antiretroviral therapy initiation among adults in Malawi: a randomized clinical trial. JAMA. 2014;312(4):372–9. - PMC - PubMed
    1. Hlongwa M, Mashamba‐Thompson T, Makhunga S, Muraraneza C, Hlongwana K. Men's perspectives on HIV self‐testing in sub‐Saharan Africa: a systematic review and meta‐synthesis. BMC Public Health. 2020;20(1):66. - PMC - PubMed
    1. Amstutz A, Lejone TI, Khesa L, Muhairwe J, Bresser M, Vanobberghen F, et al. Home‐based oral self‐testing for absent and declining individuals during a door‐to‐door HIV testing campaign in rural Lesotho (HOSENG): a cluster‐randomised trial. Lancet HIV. 2020;7(11):e752–61. - PubMed
    1. Indravudh PP, Choko AT, Corbett EL. Scaling up HIV self‐testing in sub‐Saharan Africa: a review of technology, policy and evidence. Curr Opin Infect Dis. 2018;31(1):14–24. - PMC - PubMed