{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T17:32:37Z","timestamp":1776792757665,"version":"3.51.2"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,3,20]],"date-time":"2015-03-20T00:00:00Z","timestamp":1426809600000},"content-version":"vor","delay-in-days":78,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1045125"],"award-info":[{"award-number":["OPP1045125"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of the International AIDS Society"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>HIV self\u2010testing (HIVST) has the potential to increase uptake of HIV testing among untested populations in sub\u2010Saharan Africa and is on the brink of scale\u2010up. However, it is unclear to what extent HIVST would be supported by stakeholders, what policy frameworks are in place and how variations between contexts might influence country\u2010preparedness for scale\u2010up. This qualitative study assessed the perceptions of HIVST among stakeholders in three sub\u2010Saharan countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010four key informant interviews were conducted in Kenya (<jats:italic>n<\/jats:italic>=16), Malawi (<jats:italic>n<\/jats:italic>=26) and South Africa (<jats:italic>n<\/jats:italic>=12) with government policy makers, academics, activists, donors, procurement specialists, laboratory practitioners and health providers. A thematic analysis was conducted in each country and a common coding framework allowed for inter\u2010country analysis to identify common and divergent themes across contexts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Respondents welcomed the idea of an accurate, easy\u2010to\u2010use, rapid HIV self\u2010test which could increase testing across all populations. High\u2010risk groups, such as men, Men who have sex with men (MSM), couples and young people in particular, could be targeted through a range of health facility and community\u2010based distribution points. HIVST is already endorsed in Kenya, and political support for scale\u2010up exists in South Africa and Malawi. However, several caveats remain. Further research, policy and ensuing guidelines should consider how to regulate, market and distribute HIVST, ensure quality assurance of tests and human rights, and critically, link testing to appropriate support and treatment services. Low literacy levels in some target groups would also need context\u2010specific consideration before scale up. World Health Organization (WHO) policy and regulatory frameworks are needed to guide the process in those areas which are new or specific to self\u2010testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Stakeholders in three HIV endemic sub\u2010Saharan countries felt that HIVST will be an important complement to existing community and facility\u2010based testing approaches if accompanied by the same essential components of any HIV testing service, including access to accurate information and linkages to care. While there is an increasingly positive global policy environment regarding HIVST, several implementation and social challenges limit scale\u2010up. There is a need for further research to provide contextual and operational evidence that addresses concerns and contributes to normative WHO guidance.<\/jats:p><\/jats:sec>","DOI":"10.7448\/ias.18.1.19445","type":"journal-article","created":{"date-parts":[[2015,3,20]],"date-time":"2015-03-20T15:34:40Z","timestamp":1426865680000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":55,"title":["What are the constraints and opportunities for HIVST scale\u2010up in Africa? 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