Even as various surveys have shown that in India one in four people living with HIV do not know their HIV status, the Government is yet to make HIV self Test (HIVST) as part of the HIV healthcare system as recommended by the World Health Organisation (WHO).

“Almost half of the countries (98) have included HIVST policies, and one-fourth nations globally (52) are routinely implementing it. Self-tests for Covid-19, pregnancy, diabetes, etc have not only proven successful in increasing the uptake of tests but also how it links to care services,” said Dr Ishwar Gilada, President of 14th National Conference of AIDS Society of India (ASICON) and AIDS Society of India (ASI).

He said, “there is no reason at all to delay full scale rollout of HIV self-testing in India as well as other countries which are missing leveraging upon this evidence-based intervention.”

Gilda asserted that the self tests become all the more important as the Covid-19 pandemic had  negatively impacted the pace of HIV testing. “We need to ensure that 100% of people living with HIV know their status so that they can receive full cascade of HIV care services and stay virally suppressed (undetectable viral load) – which is essential for them to live full healthy lives – as well as to end AIDS as undetectable equals untransmittable,” he stressed.

 In 2019, the WHO had recommended HIV self-testing as part of HIV care cascade, viewing it as an important approach to address gaps in HIV diagnoses, especially among key populations. A study in India that followed WHO recommendations, found that HIVST is highly acceptable to key populations (KPs) like migrants and trangenders/truck drivers though awareness about it was limited.

The study favored focus on integrating counseling and linkage to care for those availing HIVST as well as creating awareness and education, particularly emphasizing that HIVST is a screening test.

Gilda further added that since most nations could not meet 2020 AIDS targets, now the eyes are set on 2030 goal post of 95-95-95 targets (95% of people living with HIV to know their status, 95% of them should be on ART, and 95% of these be virally suppressed). HIV self-test is one of the key cog-in-the-wheel to “reaching out to the last mile” for first-95 target.

In India, as on March 2022, 77% of people living with HIV knew their status, 84% of them were on antiretroviral therapy, and 85% of them had viral suppression. This translates into 55% of total people living with HIV in India being virally suppressed in 2021-22 against the target of getting 86% of them virally suppressed by 2025-26.