About initiative

    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.

    Introduction

    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:

    1. Azerbaijan
    2. Albania
    3. Armenia
    4. Belarus
    5. Bulgaria
    6. Bosnia and Herzegovina
    7. Georgia
    8. Kazakhstan
    9. Kosovo
    10. Kyrgyzstan
    11. Macedonia
    12. Moldova
    13. Russia
    14. Romania
    15. Serbia
    16. Tajikistan
    17. Uzbekistan
    18. Ukraine
    19. Montenegro

    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

    Abbreviations

    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.

    Disclaimer

    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.

    Gratitude

    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:

    1. Orasure
    2. 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
    3. Armenia – Sergey Gabrielyan, president, New Generation Humanitarian NGO
    4. Azerbaijan – Afa Nazarli, AIDS Center
    5. Belarus – Sergey Nizkov, State Institution “Republican Scientific and Practical Center of Medical Technologies, Informatization, Management and Economics of Health Care”
    6. Bulgaria – Momchil Baev, MSc in Public Health, PhD, Program Manager for Sexual Health and HIV, Single Step Foundation
    7. Bulgaria – Elena Birinjeeva, Single Step Foundation
    8. Bosnia – Aida Kurtovic, LLB, LLM, CEO of Partnership in Health
    9. Bosnia – Damir Lalicic, project coordinator, Partnership in Health
    10. Georgia – Maka Gogia, project manager, organization Georgian Harm Reduction Network
    11. Georgia – Tamar Zurashvili, communications and administrative specialist, Georgian Harm Reduction Network
    12. Kazakhstan – Lyubov Vorontsova, project manager, ALE Central Asian Association of People Living with HIV
    13. Kosovo – Edona Deva, healthcare specialist, program manager MSHCM HIV GF, CDF – Community Development Fund
    14. Kyrgyzstan – Aybar Sultangaziev, project coordinator, head of the Association “Partner Network”
    15. Kyrgyzstan – Aibek Bekbolotov, Aibek Bekbolotov, Deputy Director of the Republican AIDS Center
    16. Kyrgyzstan – Meruert Bektemisova, Association “Partner Network”
    17. Macedonia – Andrei Senikh, Executive Director, Stronger Together, Association for Assisting People Living with HIV
    18. Macedonia – Vesna Ilievska Utevska, project coordinator, HERA organization
    19. Moldova – Ruslan Poverga, CEO A.O. “Iniţiativa Pozitivă”
    20. Russia – Kirill Barsky, Program Manager of the “Steps” Foundation
    21. Russia – Anna Markelova, Humanitarian Action
    22. Russia – Elena Romanyak, consultant Alliance Public Health Alliance
    23. Romania – Camellia Raita, project manager, Romanian Angel Appeal Foundation
    24. România – Mihai Lixandru, CFO, Romanian Angel Appeal Foundation
    25. Romania – Iulian Petre, project coordinator, legal advocate, UNOPA
    26. Serbia – Goran Radisavljevic, executive director, Timok Youth Center
    27. Tajikistan – Pulod Jamolov, head of the “SPIN Plus” organization
    28. Ukraine – Konstantin Grabitchenko “Empiric”
    29. Ukraine – Kateryna Kovalchuk, Alliance Public Health
    30. Ukraine – Kuznetsova Ulia, Alliance Public Health
    31. Montenegro – Miso Pejkovic, MD, head of NGO CAZAS

    The contact person

    Malakhova Maria
    Public Health Alliance
    malakhova@aph.org.ua