Nitika Pant Pai|Jigyasa Sharma|Sushmita Shivkumar|Sabrina Pillay|Caroline Vadnais|Lawrence Joseph|Keertan Dheda|Rosanna W. Peeling
Supervised and Unsupervised Self-Testing for HIV in High- and Low-Risk Populations: A Systematic Review
McGill University Health Centre|McGill University|McGill University Health Centre|McGill University Health Centre|McGill University Health Centre|McGill University|South African Tuberculosis Vaccine Initiative|University of Cape Town|London School of Hygiene & Tropical Medicine
stigma discrimination lack privacy long waiting times partly explain six ten individuals living hiv access facilitybased testing circumventing barriers selftesting offers potential people know serostatus recent approval inhome hiv self test us sparked selftesting initiatives yet data acceptability feasibility linkages care limited systematically reviewed evidence supervised selftesting counselling aided health care professional unsupervised performed selftester access phoneinternet counselling selftesting strategiesseven databases medline via pubmed biosis psycinfo cinahl african medicus lilacs embase conference abstracts six major hivsexually transmitted infections conferences searched 1st january 200030th october 2012 1221 citations identified 21 studies included review seven studies evaluated unsupervised strategy 14 evaluated supervised strategy strategies data acceptability range 7496 preference range 6191 partner selftesting range 8097 high high specificity range 998100 observed strategies lower sensitivity reported unsupervised range 929100 one study versus supervised range 974979 three studies strategy regarding feasibility linkage counselling care 96 n 102106 individuals testing positive hiv stated would seek posttest counselling unsupervised strategy one study extreme adverse events noted majority data n 1101912402 individuals 89 highincome settings 71 n 1521 studies crosssectional design thus limiting analysisboth supervised unsupervised testing strategies highly acceptable preferred likely result partner selftesting however studies evaluated posttest linkage counselling treatment outcomes reporting quality poor thus controlled trials high quality diverse settings warranted confirm extend findings please see later article editors summary