A self HIV test in time leaves no one behind

Swapna Majumdar, CNS Correspondent, India
Photo credit: Swapna Majumdar
It is easy to miss Hidden Corners, a community based organisation working with men who have sex with men (MSM). Tucked away in a narrow alley in a residential area in Quang Ninh in Halong, Vietnam, the building that houses Hidden Corners has no boards announcing its existence. Yet, this has not hampered their outreach. In fact, it is their low key, word-by-mouth approach that has helped to create a safe environment for the MSM community to come forward and seek services, especially those living with HIV. Considering that there are 11,000 new infections in Vietnam every year and, 30% of the 260,000 people living with HIV (PLHIV) are unaware of their status, the work of Hidden Corners has been crucial to reach out to MSMs- one of the most affected key populations.

“There are many barriers that prevent them from accessing HIV testing services, including concerns regarding confidentiality of test results, long periods of waiting time, and travel costs. So, there is low annual uptake of HIV testing,” said Hoang Long, founder, Hidden Corners.

This is where Hidden Corners is making a difference. It has been able to leverage its rapport with the community to bridge this testing gap. They have been able to convince them of the benefits of self testing HIV kits introduced by the Vietnam Ministry of Public Health in mid 2016.
“The biggest advantage of the HIV self testing (HIVST) kits is that it is private and convenient. It takes about 20 minutes for the user to obtain the test result from the simple test kit using saliva or blood sample. If the result is positive, there is no one to pass any moral judgments,” said Long.

Hidden Corners is one the community based organisations (CBOs) that is partnering with PATH, the international not-for-profit organisation that introduced HIVST in collaboration with the Vietnam Ministry of Public Health in the country last year. A prime reason for more people coming forward to test their status can be attributed to the strategy to partner with key population-led CBOs like Hidden Corners and Lighthouse, one of the first LGBTQ community led organization in Vietnam working to improve their sexual, reproductive health and rights, particularly for reduction of new HIV infections.

According to Dr Ngo Van Huu, HIV health manager, PATH, the simple and reliable service has raised the rate of HIV-testing among high-risk groups and reached a majority of new HIV testers because it was convenient as other quick tests for pregnancy or diabetes. This also led to more people accessing services after diagnosis.

Evaluation of a pilot study conducted by PATH and its partner CBOs found that 96% of the 3,155 people who self tested for HIV between May 2016 and March 2017, and were diagnosed with HIV after being confirmed by a trained tester, were enrolled in antiretroviral therapy (ART). Sharing findings of the 2017 study at the recently concluded ninth Asia Pacific Conference on Reproductive and Sexual Health and Rights in Vietnam, he said 74% of those opting for HIVST did so because it offered privacy. An equally high per cent (63.7%) chose it for the confidentiality it provided and for about 50% the short time taken to show test results was an incentive.

Duan Thanh Tung, group leader, Lighthouse, remarked that those who self tested either at home or at the CBOs said that they found this better than facing judgemental doctors and counsellors at medical faculties. In contrast, counseling by the CBO was open and friendly, and they could take the test whenever it was convenient for them. Most importantly, the self testers were sure that the information would be kept confidential and support would always be forthcoming if the results indicated HIV infection, said Tung.

This was also validated by the study finding indicating more than 97% of people stated that they would recommend it to their peers. The acceptability and willingness to pay for HIV self-testing further showed that HIV self-testing was an empowering and innovative way to reach the people living with HIV who do not know their status.

Vietnam was the first country in Asia to adopt the UN goals of 90–90–90 set for HIV prevention and control, that is, by 2020, 90% of people living with HIV know their HIV status; 90% of people who know their status are put on HIV treatment; and 90% of all people on treatment have undetectable levels of HIV in their body. Vietnam is committed to scaling up HIV self-testing services nationwide, and, to make it more widely available through the public health system, is recognition of its potential to accelerate the 90-90-90 target and leave no one behind.

Swapna Majumdar, Citizen News Service - CNS
January 3, 2018