Global funding shifts require maximizing efficiencies to sustain testing services and reach targets. 80% of HIV testing service costs are in three areas: human resources, HIV testing service (HTS) commodities, and HTS training. HIV self-testing (HST) can reduce these costs, especially personnel and commodities, supporting sustained testing momentum.

Leveraging HIVST to mitigate the impact of funding restrictions

Before February 2025, most countries in the network hadn’t embraced HIVST. Some also planned to reduce the use of HIVST kits. With the current global funding constraints leading to staffing cuts and a reduction in community-based HIV testing services (HTS), HIVST approaches have an unexplored potential to strengthen testing performance in countries, including through: 

    • Improved efficiencies in facility-based HTS, especially if used for triage. 
    • Ability to supplement or replace community-based index testing, social network testing, and venue-based testing models.  
    • Cost savings if used as a first test (A1), where appropriate, in national algorithms. 
    • Opportunities for expanded use in pediatric populations. 
    • Opportunities for expanded use within PrEP services and other self-managed care models. 
    • Opportunities for expansion and greater integration with the private sector. 
    • Opportunities for innovation in virtual HTS. 

     

    A woman wearing a patterned dress sits in front of a brick wall, smiling while brushing her teeth with a toothbrush.

    Community of Practice

    The HIV testing stream of work’s renewed focus is to provide technical assistance (TA) to countries in the CQUIN network to accelerate the adoption and scale-up of HIV testing quality, and the use of HIVST to enhance coverage, especially among prioritized populations.

    This will be done through the adoption of global best practices and recommendations, including: 

    • Use of multiple WHO pre-qualified, low-cost Assay 1 (A1) in national algorithms to ensure assured availability of testing commodities through assured availability of testing kit options and budget saving through use of low-cost test kits 

    Capacity-building activities will include webinars, focus-area calls, country-to-country learning visits, meetings, and the sharing of tools and resources. 

     

    Resources