HIV self-testing a gamechanger in curbing infections

HIV testing services (HTS) under the Directorate of Special Programmes in the Ministry of Health and Social Services provides a key entry point into care and treatment, including prevention services such as prevention of mother to child transmission (PMTCT), voluntary medical male circumcision (VMMC), pre-exposure prophylaxis (PrEP) of HIV.

Namibia has made tremendous progress in HIV testing as witnessed through the UNAIDS fast-track results measured through the 2017 Namibia Population Based HIV Impact Assessment (NAMPHIA) and the most recent programmatic results for 2020, which reveals that 90% of people living with HIV knew their status.

The remaining 10% gap shows a disproportionate testing need among men, key populations and young people (15-24 years old). For Namibia to adequately address this gap and ensure that all people living with HIV know their HIV status, there is need for targeted and streamlined testing approaches to reach the remaining high-risk individuals.

One such approach is HIV self-testing (HIVST), where a person collects their own specimen (oral fluid or blood) and then performs an HIV test and interprets the result, often in a private setting, either alone or with someone. In 2018, Namibia approved the use of HIV self-testing as an additional testing approach in line with the WHO recommendations of 2016.

How does HIV self-testing work?

HIVST allows people to take an HIV test and find out their result in a private environment of their own choice. The public is advised to use HIVST kits that are locally evaluated and approved for use in Namibia.

As such, the Ministry of Health and Social Services (MoHSS) has only evaluated and approved one type of HIVST kits which is locally available in our health facilities. The testing kits are available at Public Health facilities free of charge whereas private dispensing facilities/pharmacies may charge a fee. The kits are mainly earmarked for certain target populations who often experience challenges accessing health facilities to encourage them to know their HIV status.

The availability of HIVST in Public Health facilities is not meant to replace the existing HIV testing services administered by trained health personnel but is meant to play a complementary role through targeting those who wouldn’t otherwise get an HIV test at health facilities.

What should I expect when I use a rapid HIV self-test?

There is currently one MoHSS approved rapid HIVST kit (OraQuick) available in public and some private facilities. For this test, one must swab their gums to collect an oral fluid sample and use the materials in the kit for testing. The result should be available within 20 minutes. It is important to follow the directions as described in the instructions. If need be, additional information will be provided by service providers who distribute the kits.

If the result is negative, and you haven’t had a possible exposure to HIV risk during the previous three months, the result should be final.

If the test result is positive, you will need to go to a health care provider for a follow-up testing using the national HIV testing algorithm to confirm the HIV positive status.