Trends in HIV self-testing uptake in Africa: A modeling study of population-based surveys and HIV testing program data

by Aishi Aratrika, Carla M. Doyle, Cheryl Case Johnson, Olanrewaju Edun, Bogol Mbope, Achille Adoko, Mphotleng Tlhomola, Cédric P.

Yansouni, Augustine Talumba Choko, Jeffrey W. Imai-Eaton, Mathieu Maheu-Giroux Background HIV self-testing (HIVST) can increase access to and uptake of HIV testing among people underserved by other HIV testing approaches.

Several countries in Africa, the region most affected by HIV, have scaled-up HIVST. However, no comprehensive analysis has yet quantified HIVST uptake trends and how HIVST kits are used.

We aimed to estimate 1) country-level and regional trends in HIVST uptake among adults by sex and age and 2) the proportion of distributed HIVST kits that are used and re-testing rates with HIVST. Methods and findings Across African countries, we analyzed 1) data from national population-based surveys that included questions on previous HIVST use and 2) the number of HIVST kits distributed from nationally reported program data (2012–2024).

We developed a hierarchical Bayesian compartmental model to estimate HIVST rates by triangulating surveys and program data. Random effects were used to pool information across countries.