HIV self-testing – the path from an innovation to a necessity

Self-care and self-testing have emerged amongst the most powerful innovations and tools to advance global public health. The concept of self-testing is not new—early applications such as home-based glucose monitoring for diabetes, pregnancy tests, and cholesterol testing set the path for adoption in infectious disease [1]. The transformative potential of self-testing was demonstrated during the COVID-19 pandemic as a breakthrough enabled by lessons learned from self-testing adoption in the HIV response [2]. The HIV community led the way in pioneering diverse distribution models that expanded access, increased acceptability, promoted autonomy, and enhanced impact by embracing this empowering, person-centered approach to service delivery. Crucially, early investments in implementation research during the introduction and scale-up phase helped establish a strong and credible evidence base. In doing so, self-testing was not only normalized, but laid the groundwork for broader self-care across disease areas. These advancements would not have been possible, or available in low- and middle-income countries, without the Self-Testing Africa Initiative (STAR) [3].