World HIV Testing Day 2022: HIV testing is self-care

HIV testing is more accessible today in Nigeria than a decade ago. In all public hospitals in Nigeria, patients can walk in and request a free HIV test without an appointment. Patients can also buy a rapid test kit to check for HIV infection at home (self-testing). Uptake is, however, low especially for self-testing, an essential practice for HIV prevention and safer sex.

Healthcare facilities may use rapid test kits to confirm HIV diagnosis and initiate treatment in places with poor access to care. You can buy rapid test kits from a pharmacy for use at home. Getting tested or encouraging other people to get tested for HIV can help them stay healthy for longer.

HIV infection is transmitted through unprotected sexual intercourse, sharing sharp objects or receiving HIV-infected blood (or blood products) that were not screened. The symptoms of HIV infection are not specific, so it can only be diagnosed by testing. You can learn more about testing by reading HIV testing.

HIV self-testing is essential for arresting transmission through sexual intercourse among young people in Nigeria. With increasing access to HIV self-testing, people with poor access to public healthcare services will also find improved access to testing.

People who are not yet reached efficiently with screening services include:

• Men who have sex with men (MSM).
• People who inject drugs.
• Prisoners.

These risk groups also have some of the highest prevalence rates for HIV in Nigeria. For example, MSM, estimated to be about 1% of the Nigerian population, contributed 20% of new HIV infections in 2015.

HIV self-testing is acceptable to most young people since it is discreet, reliable and accurate. Self-testing can increase partner co-testing and improve decision-making for safer sex.

HIV self-testing though widely available in most public healthcare facilities in Nigeria at no cost, is not cheap in private facilities. Patients buying the self-test kits at pharmacies or online stores pay between N1,000 to N3,000.

HIV self-testing is self-care since it increases personal knowledge of HIV status and can guide treatment. People who use self-test kits are more aware of their risks and less likely to engage in sex without condoms. They are also more likely to be self-assured and decisive with safer sex. People who self-test can live longer, healthier lives.

There are mainly two types of self-testing kits available in Nigeria:

• Kits requiring blood to detect HIV.
• Kits requiring saliva (spit).

Young people's preferences for HIV self-testing are influenced by cost, type of test (blood or saliva), distance to a testing point, and access to treatment and support after testing. Many young people feel that HIV test kits using saliva are more convenient and less risky, but they are more expensive.

The Nigerian government can promote HIV self-testing by initiating programmes that improve access to test kits and improve education for high-risk groups:

• Decriminalize key populations and recreational drug use to enable these groups to access medical care without prejudice.
• Improve funding for HIV testing and care that meets key populations, recreational drug users and prisoners at their point of need.
• Provide HIV self-testing kits in every healthcare centre, prison and public space at no cost.
• Subsidize the cost of buying testing kits.

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