Scaling HIV self‐testing to improve health equity among cisgender gay, bisexual and other men who have sex with men, trans and gender‐diverse people in the United Kingdom: An HIV self‐testing implementation action framework.
Background: HIV self‐testing (HIVST) is feasible, highly acceptable and can increase HIV testing uptake/frequency without harm while also reducing costs. Despite HIVST's benefits, UK service provision has been sporadic partially due to policymakers and commissioners' reluctance over concerns about l...
| Published in: | HIV Medicine Vol. 27; no. 7; pp. 1038 - 1055 |
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| Main Authors: | , , , , , |
| Format: | review tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Jul2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=195154681&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 195154681 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14642662 F0I jtl: HIV Medicine issn: 14642662 maglogo: Y pubinfo: dt: Jul2026 vid: 27 iid: 7 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 195154681 193136850 195154681 195154681 10.1111/hiv.70229 195154681 ppf: 1038 ppct: 17 formats: tig: atl: Scaling HIV self‐testing to improve health equity among cisgender gay, bisexual and other men who have sex with men, trans and gender‐diverse people in the United Kingdom: An HIV self‐testing implementation action framework. aug: au: Witzel, T. Charles Weatherburn, Peter Burns, Fiona M. Chu, Isaac Y.‐H. Samba, Phil Rodger, Alison J. affil: Institute for Global Health, University College London, London, UK sug: subj: HIV Infections Diagnosis Self Assessment Health Services Accessibility LGBTQ+ Persons Men Who Have Sex With Men United Kingdom Gender Identity United Kingdom Gender-Nonconforming Persons United Kingdom Health Services for LGBTQ+ Persons United Kingdom Healthcare Disparities United Kingdom United Kingdom Multidisciplinary Care Team Collaboration Conceptual Framework Cisgender Persons Gay Men Bisexual Persons Transgender Persons Health Behavior Patient Autonomy Support, Psychosocial Patient Centered Care Implementation Science Stakeholder Participation Community Role Program Implementation Health Care Delivery Healthcare Disparities ab: Background: HIV self‐testing (HIVST) is feasible, highly acceptable and can increase HIV testing uptake/frequency without harm while also reducing costs. Despite HIVST's benefits, UK service provision has been sporadic partially due to policymakers and commissioners' reluctance over concerns about linkage to care/surveillance, which ultimately reduces user choice. Methods: We synthesized current evidence and in a multidisciplinary collaboration developed an Implementation Action Framework to facilitate and promote person‐centred HIVST provision, focusing on reducing health inequalities among gay, bisexual and other men who have sex with men (GBMSM), trans and gender‐diverse people. We do this by exploring implementation context, establishing a standard level of support for HIVST interventions and outlining intervention adaptations to support priority subgroups in the United Kingdom. Results and Discussion: A large body of published evidence demonstrates that HIVST is feasible to deliver, highly acceptable, easy to perform and can make a meaningful difference to HIV testing behaviours among GBMSM, trans and gender‐diverse people without leading to substantial harm or decreases in linkage to care. Synthesizing 29 publications from the United Kingdom or other high‐income settings, we demonstrate that the UK implementation context can be harnessed by emphasizing the need to expand testing to meet the 2030 HIV elimination goals. Concerns around linkage to care/surveillance can be addressed by highlighting successful linkage approaches and the importance of respecting patient autonomy. We establish a minimum standard level of support for HIVST interventions, including a results reporting system with a user opt‐out option, clear information on linkage to care, inclusion of a helpline and guidance to link to clinical follow‐up for those who report reactive HIVST results. To address health inequalities, person‐centred intervention adaptations include innovative approaches to HIVST delivery to reach underserved groups, provision of additional tests for other sexually transmitted infections (STIs), targeted demand generation and tailored support for the most marginalized. Conclusion: Person‐centred HIVST is critical to improving HIV testing uptake by responding to, and ultimately reducing, entrenched health inequalities in the United Kingdom. Our Framework provides a person‐centred roadmap for implementing HIVST across a range of high‐income settings. pubtype: Academic Journal doctype: review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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