HIV self-test during the time of COVID-19, India

摘要

TheJoint United Nations Programme onHIV/AIDS (UNAIDS) has setatarget ofachieving 90:90:90 by 2020. This means that 90 percent ofpeoplelivingwithHIV(PLHIV) should knowtheir status, ofwhom90 percent ofthose detected should be on anti-retroviraltherapy (ART)and90 percent ofthose onART should be virally suppressed by 2020[1]. Despitealltheefforts made by the NationalAIDS ControlProgramme(NACP) ofIndia, only 76 percent ofthe PLHIVknowtheir statusand just overa half oftheseare under the umbrella ofART[2]. The HIVepidemicis mainly concentrated among the key population groups. Therearestill pockets of untested and unreached population groups who needto beidentified.The World HealthOrganization (WHO) introduced HIVself-testing guidelines in 2016[3]. HIVself-test isan approachwherea person collects hisor her own specimen (blood or saliva),and performs this testand interprets theresultseitheralone or in the presence ofsomeone he or shetrusts[3]. The WHO pre-qualification programme was initiated to facilitatethe quality diagnosticand treatment facilities for HIV, tuberculosisandmalaria. As yet, therearefour HIVself-tests that have been pre-qualified by the WHO. The pre-qualification processapproximately takes threemonths or more[4]. Locally available HIVself-test kits havereceived national-levelapprovalin countries such as Belarus, Braziland Nigeria;however, the quality ofthese kits is still unknown[5]. HIVself-screening is viewed by the WHO asatriagestrategy thatstands to complementfacility-based testing. Africais presently leading in theimplementation ofHIVself-test,and therearesomecountries in the Asian Pacificregionsthat haveincluded this in their national guidelines or strategic plan[6],[7]. Thesescreening tests havethe potentialto increasetheaccess to HIVtesting acrossall population groups. Thelatestevidencesuggests that HIVself-testingwhen directed towards those who areat risk ofHIVinfection iscost-effectiveand also playsan important rolein early diagnosis.