A Systematic Review and Network Meta-analyses to Assess the Effectiveness of Human Immunodeficiency Virus (HIV) Self-testing Distribution Strategies.
Eshun-Wilson, Ingrid;
Jamil, Muhammad S;
Witzel, T Charles;
Glidded, David V;
Johnson, Cheryl;
Le Trouneau, Noelle;
Ford, Nathan;
McGee, Kathleen;
Kemp, Chris;
Baral, Stefan;
+2 more...Schwartz, Sheree;
Geng, Elvin H;
(2021)
A Systematic Review and Network Meta-analyses to Assess the Effectiveness of Human Immunodeficiency Virus (HIV) Self-testing Distribution Strategies.
Clinical infectious diseases, 73 (4).
e1018-e1028.
ISSN 1058-4838
DOI: https://doi.org/10.1093/cid/ciab029
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BACKGROUND: We conducted a systematic review and network meta-analysis to identify which human immunodeficiency virus (HIV) self-testing (HIVST) distribution strategies are most effective. METHODS: We abstracted data from randomized controlled trials and observational studies published between 4 June 2006 and 4 June 2019. RESULTS: We included 33 studies, yielding 6 HIVST distribution strategies. All distribution strategies increased testing uptake compared to standard testing: in sub-Saharan Africa, partner HIVST distribution ranked highest (78% probability); in North America, Asia, and the Pacific regions, web-based distribution ranked highest (93% probability), and facility based distribution ranked second in all settings. Across HIVST distribution strategies HIV positivity and linkage was similar to standard testing. CONCLUSIONS: A range of HIVST distribution strategies are effective in increasing HIV testing. HIVST distribution by sexual partners, web-based distribution, as well as health facility distribution strategies should be considered for implementation to expand the reach of HIV testing services.