The Big Picture: Benefits of HIV self testing

Professor Christopher Fairley with a
colleague, Dr Eric Chow

by Anne Crawford

"The Big Picture" will be a series profiling multicentre and international studies in which Central Clinical School (CCS) researchers and affiliates play a part.

CCS and Melbourne Sexual Health Centre researchers Professor Kit Fairley and Dr Marcus Chen were part of a multi-centre Australian study investigating whether HIV self-testing would increase frequency of testing in high-risk gay and bisexual men, with a particular focus on men who delayed testing or had never been tested before.

Frequent testing of individuals at high risk of HIV is central to current prevention strategies.

The study, published in ‘Lancet HIV’, found that HIV self-testing resulted in a two times increase in frequency of testing in gay and bisexual men at high risk of infection, and a nearly four times increase in non-recent testers, compared with standard care, without reducing the frequency of facility-based HIV testing.

It recommended that HIV self-testing should be made more widely available to help increase testing and earlier diagnosis.

Professor Kit Fairley says:

“This study is the the first published randomised trial of home self-testing – it showed no harm but considerable benefit. Prior to the study there was substantial uncertainty about how ‘safe’ home testing was. It significantly adds to the evidence in favour of regulators allowing self-testing but the tests must be purchased from reliable sources to avoid ‘sham’ products. There were no serious adverse events in the study which also reassured regulators.”

Jamil MS, Prestage G, Fairley CK, Grulich AE, Smith KS, Chen M, Holt M, McNulty AM, Bavinton BR, Conway DP, Wand H, Keen P, Bradley J, Kolstee J, Batrouney C, Russell D, Law M, Kaldor JM, Guy RJ. Effect of availability of HIV self-testing on HIV testing frequency in gay and bisexual men at high risk of infection (FORTH): a waiting-list randomised controlled trial. Lancet HIV. 2017 Feb 16. pii: S2352-3018(17)30023-1. doi: 10.1016/S2352-3018(17)30023-1. [Epub ahead of print]