Progress on the scaling up of HIV testing in South Africa through varied distribution models using the oral HIV self-test kit.

Self-Testing for HIV (HIVST) was approved as additional testing modality by the WHO in December 2016. The South African National Department of Health has adopted these guidelines and has sanctioned the assessment of various testing modalities to scale up HIV testing in response to the UNAIDS 90-90-90 targets. HIV self-tests are targeted at reaching infrequent, under-tested and high-risk populations. Herewith, we present the progress to date on the testing of various models of distribution through public and private sector initiatives. The oral test, called OraQuick HIV1/2, was the first test to be WHO Pre-Qualified for HIVST. Through the STAR Initiative, implementers have distributed oral HIVST kits to primary recipients (end-users) and secondary distribution (to networks/partners) between January 2018 and August 2019. Models of distribution in the public sector include community- and facility-based distribution which target high prevalence areas, high volume transport hubs and other facilities through which target groups can be reached. In the private sector, we have targeted workplaces, private pharmacies and waiting rooms of health professionals. For the period under review in this article, 1 231 138 were distributed. Follow-up of users is through digital platforms such as WhatsApp, Interactive Voice Response System (IVRS) and progressive web applications. Progress has been steady, and the full results of the STAR programme are expected by the end of 2020 once all tests have been distributed.