Self- Testing in HIV has been a controversial topic, and from my experience with HIV in Timor I have been very skeptical it could be successfully performed
The two sessions from Mark Bloch and Anna Mcnulty however demonstrated to me that it was a feasible and potentially useful option. First Mark Bloch spoke of advantages/disadvantages of self testing.
Self testing has many advantages. It gives people the opportunity to test themselves in a comfortable environment at a time convenient to them. They no longer need to wait hours or days for a result. And no longer need to risk multiple people being aware of their diagnosis (huge issue with health facilities in Timor, as everyone is related). It also has the added benefit of being easy to do in rural and remote environments, where people would have to travel hours to get tested.
However one of my worries has been the quality of the results, as they are more likely to be inaccurate when performed by untrained hands. on top of this the person undergoing the test may not undergo adequate counselling/ understand the significance of a positive result. Another concern centers around missing numerous other crucial tests that would also routinely be performed in those receiving HIV tests.
To my surprise however 88% of those performing a rapid HIV test in NSW were capable of following all the steps correctly (though i imagine this would be much less in a place with poor education like Timor).
Following Marks talk Anna Mcnulty went on to discuss self testing with Dry Blood Spot. This had the advantage of being easy to post to and from the household of those being tested and relatively easy to be performed. It's had a slow uptake in NSW, though the MSM community seem to be catching on.
Self-testing definitely has an important role in reaching those communities who would not otherwise engage in healthcare due to concern of confidentiality, convenience, geography and comfort.