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Potential public health benefits of HIV testing occurring at home in Australia

University of New South Wales and St Vincent's Centre for Applied Medical Research (UNSW-AMR) HIV Home Testing Assessment Group
Med J Aust 2015; 202 (10): 529-531. || doi: 10.5694/mja14.01210

Summary

  • In many countries, including Australia, policies have recently changed to support HIV self-testing. The decision has created much debate about the public health benefits of the strategy versus the risks.
  • Self-testing for HIV was approved in the US on the basis that it would facilitate greater HIV testing uptake, despite having a lower sensitivity than laboratory HIV immunoassays.
  • We calculated the frequency of self-testing that would be required among Australian gay and bisexual men at high-risk for there to be a public health benefit (detection of HIV infections that would have otherwise remained undiagnosed).
  • At a population level, if access to HIV self-testing led to men supplementing their usual sexual health check-ups (involving a laboratory HIV immunoassay) with one or more self-tests at home, or self-tests led to untested gay and bisexual men having an HIV test for the first time, there would be a public health benefit.
  • If men replaced their average of one laboratory HIV immunoassay per year with self-testing at home, then three self-tests would be needed to counteract the lower sensitivity of the self-test (so zero infections would be missed). If four self-tests were undertaken then additional infections would be detected (ie, there would be a public health benefit).
  • Additional public health benefits include a reduction in the period of undiagnosed infection, which is known to be a period of relatively high infectiousness.

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  • University of New South Wales and St Vincent's Centre for Applied Medical Research (UNSW-AMR) HIV Home Testing Assessment Group

  • Sydney, NSW.

Correspondence: Rguy@kirby.unsw.edu.au

Acknowledgements: 

Full author details are available in the Appendix.

Competing interests:

No relevant disclosures.

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