Wirtz, A., Clouse, E., Veronese, V., et al. Journal of the International AIDS Society (April 2017), 20(1): 21796, doi:10.7448/IAS.20.01.21796.
Reaching 90-90-90 goals will require novel approaches for reaching men who have sex with men (MSM), transgender women (TW), and other populations who face stigma. This formative study in Myanmar investigated the feasibility of HIV self-testing (HIVST) to improve testing and diagnosis among MSM and TW. In 2015 the authors conducted in-depth interviews in Yangon with 12 MSM and 13 TW and carried out focus group discussions with 35 participants. Both MSM and TW believed that HIVST would benefit their communities. Participants cited privacy (enabling them to avoid stigma), ease and convenience, and painlessness as advantages of HIVST. However, participants voiced concerns about the potential mental health consequences of a positive home test, especially since they believed that HIVST did not include counseling or linkage to care. Participants made the following suggestions for implementation: including some form of pre-test counseling; including psychological support; ensuring access to confidential, nondiscriminatory treatment; and launching communication initiatives to provide accurate information on HIVST and related care. The authors concluded that if implemented appropriately, HIVST could play an important role in reducing the number of undiagnosed infections and improving the overall HIV response for these key populations in Myanmar.