Several CHOICE PhD students & alumni including Samantha Clark (’22), Ben Nwogu (3rd year student), and Rachel Wittenauer (4th year student) recently co-authored a publication in The Lancet HIV titled, “Impact of self-testing for oral pre-exposure prophylaxis (PrEP) on drug resistance and HIV outcomes in Western Kenya: a modeling study,” which evaluated the impact of using HIV self-testing to inform expanded access to and use of PrEP.
The team used an agent-based network model, EMOD-HIV, to compare the impact of several HIV testing scenarios including self-testing (blood- and oral-based tests) and provider-administered testing (nucleic acid and rapid diagnostic tests) on HIV-related health outcomes, PrEP-associated drug resistance, and budget impact of PrEP provision. Results showed that PrEP provision supported by HIV self-testing led to similar reductions in HIV infections and HIV-related deaths as provider-administered rapid diagnostic tests did, and led to minimal risk of further drug resistance. Likewise, budget impact estimates of implementing PrEP were similar for HIV-self testing and provider-administered rapid diagnostic tests.
This study contributes to the growing body of evidence that supports the use of HIV self-testing to expand PrEP accessibility. Beyond this publication, findings from this study were incorporated into a 2022 technical brief for the World Health Organization (WHO) updating PrEP implementation guidance.
Cox SN, Wu L, Wittenauer R, Clark S, Roberts DA, Nwogu IB, Vitruk O, Kuo AP, Johnson C, Jamil MS, Sands A, Schaefer R, Kisia C, Baggaley R, Stekler JD, Akullian A, Sharma M. Impact of HIV self-testing for oral pre-exposure prophylaxis scale-up on drug resistance and HIV outcomes in western Kenya: a modelling study. Lancet HIV. 2024 Mar;11(3):e167-e175. doi: 10.1016/S2352-3018(23)00268-0. Epub 2024 Jan 29. PMID: 38301668; PMCID: PMC10896737.