Review of the self-testing situation in EECA
The review was conducted by consultants from the Alliance Public Health under the regional project “Sustainability of Services for Key Groups”. The review provides relevant information on the HIV self-testing status in project countries and more widely in Eastern Europe and Central Asia. The information was collected through consultations and written requests to the project’s partners in the countries – civil society organizations, government entities, international technical partners, distributors and manufacturers of self-testing kits, as well as in open sources via the Internet.
In 2016, the World Health Organization issued recommendations to include a HIV self-testing component in HIV prevention protocols. Since then, the topic of self-testing has been discussed, promoted, researched and practiced in many countries around the world. However, to date, self-testing is not an integral part of prevention approaches and efforts in all countries in the EECA region. All countries are at various stages of implementation of this intervention, from the fact that the tests are not registered in the country and are not included in any state protocols and regulations to active free sale in pharmacies, online and used in projects of non-governmental organizations and public health institutions. Also, the situation with regard to information and advocacy on this topic in countries is at different levels. Elsewhere, there has been active promotion of the issue and advocacy for the inclusion of self-testing in State protocols, and there has been little discussion of the issue.
Multiple research findings and evidence of the effectiveness of this intervention as an approach to HIV prevention, the project team felt that more detailed research was needed to inform countries, regional projects, international donors and technical partners for further action to expand self-testing interventions to more countries in the region.
In this review, we will review the current status of self-testing in 19 countries in the Eastern Europe and Central Asia region, as follows:
- Bosnia and Herzegovina
And on the following key aspects of introducing self-testing in each of the 19 countries reviewed:
- Are HIV self-testing kits registered in the country and, if so, what type of tests
- Sales to the country
- How many HIV self-testing kits are conducted per year
- Does the protocol for HIV testing include HIV self-testing
- Algorithm of actions after receiving HIV + self-test result
- Whether HIV self-testing kits are sold in a pharmacy or online and their value
- Projects in the country (last 3 years)
- Country studies (last 3 years)
- Information and media campaigns to promote HIV self-testing (last 3 years)
- Project Plans / Campaigns / HIV self-testing studies 2021 and beyond
GF – Global Fund to Fight AIDS, Tuberculosis and Malaria
HIVST – HIV self-testing
KG – key groups
LGBT – lesbian, gay, bisexual, and transgender community
MSM – Men who have sex with men
PLHIV – People living with HIV
PWID – people, who injects drugs
SW – Sex workers
ST – Self-testing
TG – transgender
Comparative overview of the situation in the region
This overview provides an understanding of the current self-testing situation in the region and outlines directions for further expanding HIV self-testing. I would like to note the most successful examples of self-testing implementation in the following countries
- Armenia, where, since 2017, a campaign has been actively conducted to promote self-tests thanks to the inexhaustible efforts of the New Generation Humanitarian NGO, which received support from the Government and international donors and changed the vector of HIV determination in the country for key populations.
- Bulgary, where self-tests are available for key groups since 2018 within the framework of projects implemented by the “Single Step” foundation.
- Ukraine, where a number of projects are being carried out to introduce self-testing.
- Kazakhstan, where self-tests are available to the public both in pharmacies and online.
- Georgia, where self-tests are available as part of projects for key populations both at the NGO office and free of charge online, while social workers collected the results of all test kits distributed, both positive and negative.
- Belarus, where, despite all the difficulties in promoting self-testing, it was still possible to expand the population’s access to tests through the pharmacy network.
Conclusions and recommendations:
We understand that changing the vector of the health system is always not an easy task, but with active, committed people, interested in expanding access to HIV self-testing status and treatment of people, countries have a great chance of introducing and scaling up this intervention.
In countries where self-tests are available only within the framework of projects for certain key groups, we, for our part, would recommend increasing the access of the general population to HIV self-tests through the pharmacy network, including online.
The information provided in this review has been gathered as much as possible from a variety of available sources. We assume that some information may not have been displayed in this review due to limited access to such information and we urge representatives of the countries of the region to contact us about the information that is presented, for clarifications and additions, as well as about the missing information.
The team expresses its gratitude to all partners and stakeholders in the countries that contributed their time and provided the information to complete this review, namely:
- Armenia – Artem Movsesyan, coordinator of the project “Prevention of HIV and AIDS among MSM, LGBT, CSW in Armenia”, coordinator of health projects, New Generation Humanitarian NGO
- Armenia – Sergey Gabrielyan, president, New Generation Humanitarian NGO
- Azerbaijan – Afa Nazarli, AIDS Center
- Belarus – Sergey Nizkov, State Institution “Republican Scientific and Practical Center of Medical Technologies, Informatization, Management and Economics of Health Care”
- Bulgaria – Momchil Baev, MSc in Public Health, PhD, Program Manager for Sexual Health and HIV, Single Step Foundation
- Bulgaria – Elena Birinjeeva, Single Step Foundation
- Bosnia – Aida Kurtovic, LLB, LLM, CEO of Partnership in Health
- Bosnia – Damir Lalicic, project coordinator, Partnership in Health
- Georgia – Maka Gogia, project manager, organization Georgian Harm Reduction Network
- Georgia – Tamar Zurashvili, communications and administrative specialist, Georgian Harm Reduction Network
- Kazakhstan – Lyubov Vorontsova, project manager, ALE Central Asian Association of People Living with HIV
- Kosovo – Edona Deva, healthcare specialist, program manager MSHCM HIV GF, CDF – Community Development Fund
- Kyrgyzstan – Aybar Sultangaziev, project coordinator, head of the Association “Partner Network”
- Kyrgyzstan – Aibek Bekbolotov, Aibek Bekbolotov, Deputy Director of the Republican AIDS Center
- Kyrgyzstan – Meruert Bektemisova, Association “Partner Network”
- Macedonia – Andrei Senikh, Executive Director, Stronger Together, Association for Assisting People Living with HIV
- Macedonia – Vesna Ilievska Utevska, project coordinator, HERA organization
- Moldova – Ruslan Poverga, CEO A.O. “Iniţiativa Pozitivă”
- Russia – Kirill Barsky, Program Manager of the “Steps” Foundation
- Russia – Anna Markelova, Humanitarian Action
- Russia – Elena Romanyak, consultant Alliance Public Health Alliance
- Romania – Camellia Raita, project manager, Romanian Angel Appeal Foundation
- România – Mihai Lixandru, CFO, Romanian Angel Appeal Foundation
- Romania – Iulian Petre, project coordinator, legal advocate, UNOPA
- Serbia – Goran Radisavljevic, executive director, Timok Youth Center
- Tajikistan – Pulod Jamolov, head of the “SPIN Plus” organization
- Ukraine – Konstantin Grabitchenko “Empiric”
- Ukraine – Kateryna Kovalchuk, Alliance Public Health
- Ukraine – Kuznetsova Ulia, Alliance Public Health
- Montenegro – Miso Pejkovic, MD, head of NGO CAZAS