Govt relaxes age for HIV self-test kit users

Government has relaxed the age of people who are eligible to use OraQuick HIV self-test kit from 18 to 17 years and above, an official from the Ministry of Health has said.

The move is aimed at increasing access to stigma-free HIV testing services.

In an interview with the Monitor yesterday, Mr Geoffrey Taasi, the programme officer of HIV testing services at the ministry, said the decision to relax the age was informed by the findings of a study which found that there was no social harm associated with using OraQuick HIV self-test kits, in addition to offering accurate HIV test results.

He did not specify which study it was, who conducted it and what it was about.

OraQuick is an HIV self-test product of Orasure Technologies. It was launched by the Ministry of Health in 2020.

“Initially, self-testing was restricted to people who are 18 years and above, key populations such as sex workers and men. We could give kits to women during antenatal visits and they would take them to their spouses to use at home. But when the study found out that no social harm like committing suicide upon testing HIV-positive was reported, we relaxed the policy to include adolescents of 17 years,” Mr Taasi said.

“The latest addition are children between two and 14 years. If we have an HIV-positive mother under our health care system and they have a child at home who has not tested for HIV, we give her OraQuick HIV self-test kit to test the child from home,” he added.

Initially, young people aged 18 and 24 years, men, and key populations including sex workers were targeted.

Mr Taasi said when someone does a self-HIV test and it shows that they have the disease, they are advised to go to a health facility for a confirmation HIV test.

If a confirmatory test is positive, the patient is immediately started on Antiretroviral Therapy (ART).

He added that those who test negative are advised to test again after three months to be sure of their status.

How OraQuick HIV Self-Test kit works

Mr Taasi said the test works by detecting antibodies, the body’s natural defenders against infection. When someone is infected with HIV, the antibodies can be present in the blood or oral fluid.

He said the OraQuick HIV self-test kit and other HIV self-test kits have been validated by the Uganda Virus Research Institute (UVRI).

“The self-test kits that we have approved have met the standards recommended by the World Health Organisation (WHO) and by Uganda. Before we think of whether we should validate a kit or not, they must be approved by WHO first and as a country, we also have our protocols,” he said.

Mr Taasi said so far, WHO has approved about seven self-test kits while Uganda has approved five, of which four are blood tests and the last one is the OraQuick HIV self-test kit.

He said studies have been done to determine the accuracy of HIV results that these kits produce when used.

“We found that accessibility was high but also the results that users were getting were accurate because researchers would do confirmatory tests for all tests done by individuals, be it negative or positive,” he said.

He revealed that although the government had established youth-friendly corners, adjusted the time for testing for HIV in health facilities to include weekends and evenings, and encouraged men to test after work, many people are still scared of going for testing.

Ms Shamim Naggayi, the product manager for OraQuick HIV self-test kit, said the kits are available in both public and private health facilities and pharmacies.

She said those in public health facilities are free while private service providers sell the kits for between Shs15,000 and Shs25,000.

Ms Naggayi said embracing both self-testing of HIV and hospital-based testing would enable the country to realise the ambitious target set by the United Nations Programme on HIV/Aids (UNSAIDS).

In 2014, UNAIDS set ambitious targets dubbed 95-95-95 which tasks member states including Uganda to ensure that at least 95 percent of people living with HIV know their status, 95 percent of those who test positive receive Antiretroviral Therapy (ART,) and that 95 percent of those on treatment achieve viral suppression by 2025 to end HIV as a public health problem by 2030.

Dr Diana Atwine, the Permanent Secretary of the Ministry of Health, said Uganda will be able to achieve the 2030 target only when 100 percent of Ugandans know their status and those who are infected seek and adhere to treatment.

“It feels very sweet to say you have achieved 95-95-95 targets but we must also focus on the remaining five percent. It is just a [matter ] of time [before] we can go back to 70 percent,” Dr Atwine said.

Dr Atwine noted that despite progress made in eliminating vertical HIV transmission, there remain gaps in identifying and testing all children and adolescents infected with HIV, ensuring breastfeeding and pregnant adolescents and young women access prevention of mother-to-child transmission of HIV (PMTCT).

While officiating at the launch of the Global Alliance to end Aids in children by 2030 at Kampala Serena Hotel last week, Dr Atwine said the perinatal HIV infection of 56,000 is still high.

ABOUT HIV IN UGANDA

Statistics from the Uganda Aids Commission (UAC) fact sheet for 2023 indicate that 5,900 people were infected with HIV through mother-to-child transmission in 2022, a reduction from 20,000 in 2010.

The fact sheet indicates that of 52,000 new infections were registered in 2022, 19,000 were among young people aged 15 to 24 with young women disproportionately affected, contributing 15,000 of the cases. Similarly, of the 86,000 new infections in adolescents, 8,000 were girls.

UAC estimates that Uganda registers 1,000 new HIV infections and 500 related deaths per week.

A study done in 2020 revealed that about 20 percent of people who were living with HIV had not yet been identified.