Innovative HIV self-testing study empowers young women in rural South Africa

A Public Health research unit at Wits University is leading a study that enables young women in rural South Africa to test themselves for HIV.

The study forms part of a World AIDS Day programme presented by the Faculty of Health Sciences at Wits on Thursday 1 December from 13:00.

The MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), in partnership with the University of North Carolina and the University of California, San Francisco, has launched a study into a new method of HIV testing that can be performed by individuals themselves.

This self-testing study takes place in Agincourt, Bushbuckridge, Mpumalanga. The rationale is to investigate if improvements in HIV prevention and its linkage to care can be achieved through a more accessible HIV testing method – particularly in rural communities.

Zola Myakayaka, study project manager, says: "A major challenge in the fight against HIV/AIDS has been late diagnosis. Patients often present with an already critically low CD4 count when they arrive for HIV testing at clinics. This results in a longer, more difficult treatment process. Early diagnosis would allow them to be placed onto immediate Anti-Retroviral Treatment (ART), significantly reducing the risk of opportunistic infections and allowing for a relatively quick recovery to normal CD4 levels."

This study will explore self-testing as an early diagnosis method. People are often reluctant test at clinics due to queues and stigma. Self-testing, which involves a simple saliva test (in this particular study), or a blood test by finger prick, can be performed at home. This bypasses the clinic setting and may reduce the time between contracting HIV and initiating treatment. 

Women aged 18-24-years will participate in the study and extend the self-test to their friends and partners. Participants will be randomised into a group who test at a clinic and a group who can choose between clinic and self-testing.  The study will determine whether young women, given the choice to self-test, will do so at a greater rate than those offered only clinic testing. The study will also determine if integrating people from participants' social-sexual network will increase testing uptake, thereby increasing detection of previously undiagnosed infections.