Acceptability and feasibility of HIV self-testing in Southeast Asia: A scoping review

Abstract

Background: HIV self-testing (HIVST) policies in Southeast Asia are under development. This scoping review aimed to systematically synthesize the available literature on the acceptability and feasibility of HIVST in Southeast Asia.

Methods: Systematic search was conducted on January 20, 2022, in eight databases: PubMed/MEDLINE, CINAHL, Web of Science, Academic Search Complete, SocINDEX, PsycINFO, PsycArticles, and CENTRAL. Acceptability (HIV testing frequency, willingness to pay, use, and recommend the test, ease of use, preference over standard tests, and partner testing) and feasibility (error rate, readability, and diagnostic performance) parameters were followed for the inclusion of articles. A narrative synthesis was done to present findings from included studies on the acceptability and feasibility of HIVST.

Results: A total of 5091 records were identified through database search, and 362 were deleted after deduplication. The screening process resulted in 18 studies that met the inclusion criteria. Results indicated a high acceptability rate due to convenience, increasing awareness about HIVST, availability, and affordability of test kits, and confidentiality of test results. A high feasibility rate was reported due to a low occurrence of errors in self-testing, interpretability of results, and a low percentage of invalid and false-reactive results. Issues identified include costs of HIVST for individual use, distribution mode, type of supervision, counseling, geographic location, and socioeconomic status.

Conclusions: Evidence supports the acceptability and feasibility of HIVST in Southeast Asia. There is a need to regulate and license HIVST in Southeast Asia to have better recognition as a supplement to HTS.

Keywords: Acceptability; HIV; HIV self-testing; Southeast Asia; feasibility; human immunodeficiency virus.