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Prof. Anne-Claude Crémieux Hôpital Saint-Louis Université Paris 7

Satellite Session HIV Self-Testing: Evidence for Action: Key Findings from the HIV S elf- T esting A f r ica (STAR) Project in Malawi, Zambia and Zimbabwe. Prof. Anne-Claude Crémieux Hôpital Saint-Louis Université Paris 7. France: concentrated HIV epidemic. Key populations MSMs

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Prof. Anne-Claude Crémieux Hôpital Saint-Louis Université Paris 7

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  1. Satellite Session HIV Self-Testing: Evidence for Action: Key Findings from the HIV Self-Testing Africa (STAR) Project in Malawi, Zambia and Zimbabwe Prof. Anne-Claude Crémieux Hôpital Saint-Louis Université Paris 7

  2. France: concentrated HIV epidemic • Key populations • MSMs • Individuals from sub-Saharan Africa • Metropolitan Paris region: 42% of France’s new HIV diagnoses • Undiagnosed HIV infections • 16% of people living with HIV unaware of their infections • Almost exclusively in high-risk populations • Tested 3 to 5 years before but never retested ++ Encourage key populations to be retested (Crémieux, D’Almeida, Lert, Semailleet al, Archives of Internal Med 2012, Plos One 2013, AIDS 2012)

  3. Is self-testing able to reduce the number of undiagnosed infections by encouraging key populations to repeat tests? • 2013: French Ministry of Health legalized HIV self-testing • September 2015: whole-blood rapid self- HIV test was available in pharmacies • 140,000 tests have been sold in French pharmacies • 2017 joint initiative of the President of Metropolitan Paris Région, ValériePecresse, and the Mayor of Paris, Anne Hidalgo, for free or low-cost HIV self-tests. • French Center for Disease Control (“Santé Publique France”): REMIND study (ongoing)

  4. HIV Self-Testing in Africa, the STAR Project • In Southern Africa, the epidemic is generalized and HIV still affects up to 20% of the adult population. • 40% of people living with HIV are not aware of their infections. • HIV-screening rate is still insufficient for men. • The epidemic also disproportionally affects adolescent girls and young women, sex-workers, and MSM.

  5. People want to be tested at the moment they are ready

  6. Satellite Session • Results on the public health impact and cost-effectiveness of HIV Self-Testing. (London School of Hygiene and Tropical Medicine, University College London, Liverpool School of Tropical Medicine, and Population Services International, Malawi, Liverpool Wellcome Trust, ZAMBART, CESSHAR Zimbabwe) • Discussion with panelists on the remaining research questions that will be addressed during the next phase of the STAR Project, extension toSouth Africa, Lesotho and Swaziland • Official launch of the next STAR phase with UNITAID, PSI, Society for Family Health and the South African Ministry of Health’s

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