Objectives: To review methods for measuring HIV self-testing (HIVST) among key populations, including both
conventional approaches and implementation science approaches.
Methods: We reviewed the literature on evaluating HIVST among key populations.
Results: Simple HIV self-tests have already entered markets in several regions, but metrics required to demonstrate the
benefits and costs of HIVST remain simplistic. Conventional measurements of sensitivity, specificity, acceptability, and
behavioural preferences must be supplemented with richer implementation science measurement tools and innovative
research designs in order to capture data on the following components: how self-testing affects subsequent linkage to
confirmatory testing, preventive services and onward steps in the HIV continuum of care; how self-testing can be marketed
to reach untested subpopulations; and how self-testing can be sustained based on overarching organisational and financial
models. We outline an implementation science research agenda that incorporates these components, drawing from
evaluation study designs focused on HIVST and testing in general.
Conclusion: HIVST holds great promise for key populations, but must be guided by implementation research to inform
programmes and scale up
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