Can Self-testing Curb HIV Transmission in Africa?
Supporters say program can help limit infection while others worry that without adequate counseling and treatment options it will have little impact
HARARE — Zimbabwe is one of four southern African countries rolling out free HIV self-testing kits this month. Experts say making it easier for people to find out their status will curb the spread of HIV, but others worry that testing without adequate counseling and treatment options will have little impact. Despite the concerns, Zimbabwe is optimistic that self-testing kits can help it prevent new HIV infections. A quick thumb prick and in a matter of minutes the test kit can tell the tester if you he or she is HIV-positive or not. The kits are already available in some pharmacies. They cost about $5. But a new program, funded by the international NGO UNITAID, will soon begin distributing them for free over the next four years so researchers can evaluate their effectiveness. Zimbabwe’s national HIV prevention coordinator, Gertrude Ncube, said the self-testing kits are convenient and discreet. “Those who are afraid of someone to know their HIV status, they will be able to test themselves and interpret the results themselves at their home environment. Basing on studies done elsewhere like in Malawi, it was actually found that men were actually forthcoming with self-testing. So we are hoping that even here in Zimbabwe, especially males who are always busy at work, they will be able to take the self-testing kits and test themselves,” Ncube said. Only 34 percent of men in Zimbabwe know their HIV status, compared to 56 percent for women, according to data collected by the country's government. In some African countries, the same data shows, the percentage of men who know their HIV status can be as low as eight percent. In theory, once people know they are infected, they can begin treatment and learn how to not transmit the virus to others. But some Zimbabweans are skeptical. The self-test kits are not a magic bullet, Mire Maponga said. “As soon as I know my results, what do I do? From there is no adequate counseling. Let us not assume that everyone is in the know about HIV. Yes, we want to act like we want to normalize (remove stigma), but in the process, it is not yet like normalize as we would want it to be, I fear,” Maponga said. Stephano Gudukeya works with Population Services International, one of the organizations running the HIV self-testing program in Zimbabwe. “Community health workers are going to be available to assist. They might test regardless of their results, if they need any further information, they need support, even assistance in interpreting their own results or options they can take after testing. We also have a toll-free line that people can call and talk to a counselor at any time, and this should be able to provide further support to people that test,” Gudukeya said. Malawi, South Africa and Zambia are also taking part in the initiative. At the moment, Kenya is the only other African country to have officially adopted HIV self-testing kits, though they can be found for purchase in other countries like Namibia and Tanzania. According to various studies, of the approximately 34 million HIV-positive people worldwide, about 69 percent live in sub-Saharan Africa.