HIV self-testing: a new tool in our toolbox
HIV self-testing has arrived in Canada! As we reported a few months ago, the Public Health Agency of Canada (PHAC) announced new funding to increase access to HIV self-testing. Since then, community-based organizations across the country have been distributing HIV self-test kits for free, as well as supporting their clients to use them. Distribution began in November 2022 and is expected to continue at least until March 2023.
Together with PHAC, Communities, Alliances & Networks (CAAN), CATIE, Community-Based Research Centre (CBRC) and REACH Nexus are collaborating to support frontline workers to incorporate self-testing into their services. We are working with communities to develop distribution processes, as well as provide resources and training to help get HIV self-test kits into the hands of people who can benefit.
What are the benefits of HIV self-testing?
HIV self-tests are an effective, low-barrier option that can increase uptake of HIV testing for people who may not otherwise access it. They are one more tool in our HIV testing toolbox and a great option to help reach the undiagnosed in Canada. Reaching the undiagnosed matters, as knowing one’s HIV status is an important first step toward taking care of one’s health and starting life-saving treatment. Testing can also be a gateway into prevention services.
The goal of providing self-test kits is to ensure that testing is increasingly accessible, especially to individuals and communities who encounter barriers to access, such as people who face stigma, people living in remote or isolated communities and people with limited access to healthcare.
How can people access HIV self-test kits?
Community-based organizations can order HIV self-test kits through one of three pan-Canadian organizations: CATIE, CBRC and REACH Nexus. Each kit comes with easy-to-follow instructions, as well as information about self-testing and where to go for more resources and support. Over 100 organizations have started to distribute HIV self-test kits and many more are interested in joining.
Some individuals might feel more comfortable ordering kits online and they can do so directly through CBRC or CATIE, who will deliver them in discreet packaging anywhere in Canada. Orders can be placed through the CATIE Ordering Centre or through CBRC’s Test@Home.
What about linkage to confirmatory testing, treatment and prevention?
The HIV self-test approved in Canada is highly accurate, but Canadian guidelines recommend that individuals with reactive results undergo confirmatory testing, as well as follow-up care and support through their healthcare provider or a local HIV service provider. People who use the self-test kit may also seek referrals to HIV prevention, mental health services and more. Community-based organizations are really well suited to make these linkages, but they need to know where to refer people.
To support this, REACH Nexus has mapped pathways to care in each province. Some community-based organizations are also creating their own referral lists to provide more local pathways and CBRC is actively supporting these efforts. CATIE’s website Where To? also includes a large database of HIV services across the country to support referrals. Together, we are working to gather the information that service providers need to best support their clients who self-test for HIV.
What next?
HIV self-testing is an extension of Canada’s HIV testing infrastructure, not a replacement. We know that HIV self-testing reaches communities that face structural inequities in accessing the healthcare system. With 10% of HIV-positive Canadians still undiagnosed, we need to use every tool at our disposal to link them to diagnosis, treatment and care.
For more information, or to sign up to distribute HIV self-tests, please contact Ayibatonye (Tonye) Oriakhi at aoriakhi@catie.ca and she can direct you to the right place.
Ayibatonye (Tonye) Oriakhi is a registered social worker and joined CATIE in December 2022 as HIV self-testing project officer. Tonye is passionate about social justice and equity issues, as well as helping her community. She co-organizes the annual Afrofest Sudbury and is the president of the Nigerian Community Association of Greater Sudbury.
Christie Johnston is the director of education and capacity building with CATIE and she is supporting CATIE’s efforts to support HIV self-testing distribution in Canada.