HIV SELF-TESTING: THE THAI EXPERIENCE

Praphan Phanuphak, MD, PhDDirector, the Thai Red Cross AIDS Research Centre

Bangkok, Thailand

Current status• HIV self-testing is not legally allowed. No HIV ST kit is licensed in

Thailand • Has to be carried out by laboratory technician or MD in clinical settings• OraSure failed registration evaluation process, illegally used in life

insurance application• The need to change laws & regulations to allow HIV ST was approved

by National AIDS Committee in Feb 2015 , this included non-saliva ST• Committees were set up in June 2015 to work on the necessary

components such as public acceptance, public education, pre-test information, testing instruction, post-test linkage to care and retesting, target population and demonstration projects in KP, ST kit registration, market outlets of ST, etc.

• Attempts have been made by TRCARC to establish HIV testing in community workers (MSM/TG) through proper training and continuous QA/QI support (i.e., task shifting) using finger-prick RDT (screening & confirmatory tests) as a part of community-based Test & Treat project for MSM/TG supported by USAID

• USAID (FHI360) is planning a preliminary study of acceptability and accuracy of HIV ST among MSM/TG in the community outreach together with qualitative research in late 2015

• Online supervised real-time MSM/TG self-test, an online test and treat study supported by amfAR

Current status

What is needed?• A strong WHO recommendation for HIV ST: without fear of inappropriate use or

suicidal attempts • Guidelines/Guidance :

• On who needs ST, measures to prevent inappropriate use and to prevent suicidal attempt, criteria for referral to more sensitive test if initial ST is negative; how to link to care and treatment

• Guidelines and technical assistance for ST kit registration in a country and guidelines for ST kit selection by consumer (if >1 ST kits are available)

• For pilot projects to demonstrate acceptability and accuracy• Price reduction of ST kit: repackaging, or cost-free use of the existing

educational materials related to ST• More sensitive 3rd Gen (saliva or urine) or 4th Gen (finger-prick) ST kit with

affordable price• Demand generation for HIV testing in general