GOVERNMENT has not yet rolled out HIV self-testing kits yet most pharmacies around the country are already selling the unapproved self-test kits for US$5 per kit.
The unapproved self-test kits have been on the shelves since January this year.
Investigations by The Patriot show that the HIV self-testing kits are still undergoing assessment and Government is yet to roll out the project.
The first phase of Self-Testing in Africa (STAR), whose aim was to ascertain the acceptability and feasibility of self-testing by Zimbabweans, was concluded last year.
Results from the first phase revealed that for the second phase of the pilot project to succeed, a number of issues need to be looked into and addressed.
Government is expected to roll out the project to the country’s 12 districts targeting over
375 000 people this month.
Sponsored to the tune of US$23 million, the project is also running in South Africa, Malawi and Zambia.
Self-testing kits were introduced with the hope of encouraging more people to know their HIV status.
HIV self-testing kits, also known as self-tests, allow people to test themselves without the aid of a healthcare provider.
The kit allows an individual to test a blood or saliva sample and interpret the result within 20 to 40 minutes.
What this means is that one can test for HIV the same way you are able to test for pregnancy at home.
Only individuals above 16 years old will be permitted to collect self-test kits.
However, there are split opinions concerning the issue of HIV self-testing kits in the country.
The question that begs for an answer is how then will a person who tests positive react to the results since he/she would probably be alone in his/her bathroom?
A Nyanga man who could not cope with testing positive for HIV recently took his own life by drinking a pesticide.
According to police, Allois Nyamangodo (43), of Mashava Village, went to Mutare Provincial Hospital on February 15 to seek medical attention.
He was advised to go for HIV testing and the results came out positive prompting him to take his life.
Such incidents are testimony to the fact that the issue of HIV self-testing is still very sensitive and needs to be tackled accordingly.
Addressing journalists at an HIV and AIDS workshop organised by National Aids Council in Macheke last week, Amon Mpofu, NAC Monitoring and Evaluation director said there was a need to educate the general public on the kits before they are rolled out.
“The public needs to be educated on the kits so that when they are in circulation there is high uptake because if they just storm the market when people have little education they may be counterproductive.
“Campaigns should be done throughout the country too to give people a better understanding on what the kits are about,” said Mpofu.
Recent estimates from the Joint United Nations Programme on HIV/Aids indicate that approximately 1,2 million Zimbabweans aged 15 years and older are living with HIV/Aids but most of them are yet to be tested.
NAC says self-testing will reduce transmission of the virus.
“Self-testing is very expensive as it consumes more resources than any other method since one has to undergo the clinical testing for confirmation,” said Mpofu.
“It is not final because it needs a confirmatory test which will determine what type of therapy one has to go, one cannot just undergo therapy with the self-testing technique.”
However, the main concern is that there may be an upsurge of people who contemplate suicide as they would not have received counselling.
One counsellor based in Harare, who spoke on condition of anonymity, said there was a risk of suicides increasing in cases where there is no counselling.
“There is a high risk that those who test positive may be suicidal to a greater extent as they will not have immediate counselling based on their results,” he said.
“Pre-test and post-test counselling is very critical in dealing with HIV.
“We might just have a problem if this is not addressed.”
He said there is also concern about psychological reactions when receiving a positive result in isolation.
In addition, how accurate are the results and will users trust them?
Another significant concern is false-negative results or missed infections in the window period, especially because these early infections often exhibit high viral loads and elevated transmissibility.
“If individuals with frequent HIV risk behaviour are accessing the test, which is the goal, a negative test during the window period may lead to false reassurance, which may increase unprotected sex with HIV-negative partners and thus propagate transmission,” he said.
This ‘risk compensation’ has potentially dire consequences.
Early versions of the home-testing kit were banned in some countries due to the concern that false-negative tests could lead to false reassurance and that positive results would lead to suicide and other adverse reactions.
Concerns over ‘inaccuracy and risks of suicide’ have surrounded self-tests since the mid-1980s.
Also noted in the first phase of STAR in Zimbabwe was failure by participants, especially those in rural settings, to understand instructions on self-testing kits.
As a result, the ministry is simplifying the instructions and incorporating illustrations for easier understanding.
The instructions will be translated into local languages.
Failure to understand instructions often results in participants incorrectly drawing blood and saliva samples.
Research in Singapore shows that 85 percent of people sampled failed to perform all steps properly when self-testing.
Participants had problems with blood sampling and 56 percent had invalid results because of incorrect test performance, with 12 percent of the participants unable to correctly interpret results.
The research also indicated that 89 percent of participants preferred testing in private, although most indicated that confidential counselling by specialists was necessary.
Furthermore, if individuals are testing at home for fear of stigma and discrimination, they may also choose to avoid linking or presenting to care for the same fears.
An additional criticism of self-testing is the potential for gender-based or partner-based violence
However, the procedure has been received fairly well in some sections of the society.
In addition to high acceptability an argument for HIV self-testing is the empowerment of individuals and the reduction of stigma, as well as the ability to test in an anonymous, confidential and private manner.
Stigma and discrimination remain huge barriers to HIV testing in health care settings, as are fears of confidentiality breaches and long wait times to receive results.
However, the main fear is self-kits are already on shelves for the public yet many questions linger.
Hence more data on the risks of self-testing are crucial so that the dangers of self-testing can be addressed and this testing modality can be applied to large public health campaigns productively and safely.