Project Lead(s): Nitika Pai
Issue
Almost half of all HIV cases in low-resource countries are undiagnosed, because of the stigma and discrimination associated with HIV and because of concerns around the privacy and confidentially of conventional HIV testing in public health facilities.
This is a significant health challenge (both for those individuals who remain undiagnosed and untreated) as well as a major public health challenge, as these individuals pose a significant risk to transmit the disease to others, thereby jeopardizing the control of HIV in the community. Democratization of self-testing will help end the HIV epidemic.
Solution
Implemented in South Africa, HIVSmart! is an innovative, global HIV self-testing, counselling and linkage strategy that offers a de-stigmatized, private and confidential self-testing option through the use of an application on a 'smart' phone, tablet or the web.
HIVSmart! is a multilingual, engaging, Android smart phone/web application that walks a self-tester through the process of self-testing and counselling, and assists in rapid linkages to clinical care.
Outcome
The HIVSmart! strategy has been pilot tested in 251 healthcare workers in South Africa (PLOS One, 2013 (Pant Pai, 2013)). In this study, 100% of those who self-tested positive for HIV using HIVSmart! sought counselling and referrals to care; and 91% rated it as a positive experience because of the privacy, ease of use and convenience it offered to the participants.
In 2013, the HIVSmart! strategy was awarded the Accelerating Science Award Program (ASAP) open access innovation award from Google, Public Library of Science (PLOS) and Wellcome Trust.
Using the strategy in a transition-to-scale project, the team aims to screen 1,500 at-risk people in communities and link them to counselling and care.
Grand Challenges Canada is providing up to $1 million in funding to support the scale-up of this self-testing strategy in South Africa. The scale-up is also supported financially by partners: the Research Institute of McGill University Health Centre (Montreal), the Department of Science & Technology, South Africa, and Medical Research Council, South Africa.