Bibliographic information
GuidelineConsolidated guidelines on differentiated HIV testing services.
Year of Publication2024
Issuing InstitutionWorld Health Organization
Recommendation
Maintained
HCV self-testing should be offered as an additional approach to HCV testing services
Recommended in favor
Strong
Certainty of evidence
Moderate
Notes and Remarks
- 1.Design service delivery models: match models to focus populations. Consider who are the intended users (members of key populations or populations from specific age groups, social and/or sexual contacts); where are kits distributed (facilities, other fixed sites, communities, mobile outreach services); when and how are kits distributed (timing and frequency – ongoing, occasional, or event-/campaign-based); who distributes kits (in-person – providers, peers, clients; automated – vending machines; home delivery).
- 2.Optimized support tools and options*: define a minimum support package for self-testers during and after self-testing (in-person, videos, virtual, hotlines).
- 3.Referral pathways: develop efficient and effective pathways for confirmatory testing and linkage to services including prevention, treatment and care.
- 4.Training of providers and distributors Integration with other services such as HIV self-testing programmes (depending on epidemiology) may reduce costs. Self-testing refers to a process whereby people collect their own specimen using a simple rapid test and then perform the test and interpret their results when and where they want. WHO recommends a range of self-testing approaches which can improve access to and uptake of testing services, including those for pregnancy (40), HIV (11), HCV (41), syphilis and COVID-19 (42) (see for example, Figure 5.1). New dual self-tests, which can detect syphilis and HIV infection at the same time, are also recommended (43). See Box 5.8 for a summary of self-testing recommendations. Self-testing has been consistently shown to be safe, acceptable, and effective in increasing the number of people tested, diagnosed with and treated. While efforts to optimize linkage are important, studies have consistently shown that linkage rates following self-testing continue to be high and comparable to standard testing (44-46). The empowering nature of self-testing has also enabled people, including partners and people with limited contact with the health system, to access testing along with onward prevention, care and treatment services. Self-tests could be distributed through pharmacies, vending machines, pick-up from a local store, distribution by peers, community-based distribution, online ordering, mail delivery and facility-based distribution. Self-testing can enable greater flexibility for clients and health services, particularly as part of simplified implementation of PrEP and PEP services (3). A range of support tools can be utilized to support self-testing implementation (47), including virtual interventions and artificial intelligence (48). Evidence has shown that both blood-based and oral fluid-based self-tests are acceptable, and different users have different preferences (49-60). There is currently no evidence that there are differences in user uptake when offering either blood-based or oral fluid-based self-tests. There are currently a range of affordable WHO prequalified self-tests that can be accessed: https:// extranet.who.int/prequal/vitro-diagnostics/prequalification-reports/whopr.
Also Featured In
This recommendation also appears in the following guidelines:
Originally Developed
Guideline
Recommendations and guidance on hepatitis C virus self-testing
Year2021
InstitutionWorld Health Organization
Guideline
Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations
Year2022
InstitutionWHO