Community Health Workers: The True Heroes of HIV Self Testing

Justin Matheson-Turner, Intern

The UNITAID/PSI Self-Test AfRica (STAR) consortium were joined by members of the Ministries of Health from Zimbabwe, Zambia and Malawi, as well as PSI Global Ambassador Debra Messing, last week in Blantyre, Malawi. The team learned firsthand how making HIV testing easier and more accessible can lead to getting people on treatment sooner.

They met with village leaders, as well as couples and individuals testing themselves for the very first time. However, it was clear that the community health workers who go door to door to offer HIV self-testing kits are vital to the success of PSI’s STAR program.

Community distributor Vileta earns the trust of villagers like Rhoda because she offers HIV self test kits that are affordable — often free — and easy-to-use. She also explains exactly what comes next if Rhoda were to test positive and how she can get linked to care near her. Rhoda will have this information whether she chooses to test with Vileta or after Vileta leaves Rhoda’s home.

Less than 50% of all people living with HIV are aware of their status. Community-based distributors are not only distributing HIV self-testing kits, but also gathering the information needed to make sure that when STAR partners, like the World Health Organization, expand the effort it’s effective, ethical and efficient.

Matilda’s husband Gilbert just had his first HIV test, which he administered himself, without a needle. Community-based distributors shared with Debra Messing and UNITAID’s Robert Matiru that men often won’t go to a clinic given how long it takes to walk there, the stigma of getting tested for HIV and the shame they feel standing in line with women. By providing home-based HIV tests the STAR project gives people another way to know their status and we help overcome many of the barriers that keep people from getting tested in clinics.

Adolescent girls and young women are often stigmatized if they go to a clinic to get tested for HIV. Testing privately helps overcome obstacles even beyond stigma and discrimination, including policies such as “age of consent” laws, cost of seeking services, long lines, lack of privacy and confidentiality, and reports of poor quality HIV testing. Bringing the opportunity to test in the place and time of her choice can help lead to an AIDS-free generation.

Universal truths are rare, but at least in my experience, one of them is that community health workers (midwives, nurses, peer educators) are some of the baddest broads in any country. This is Veronica, who distributes HIV self-tests to eight villages with more than 100 households each in Malawi, and teaches people how to use the the tests and how to link into the formal health care system if they're positive. In her backpack are testing kits, demos, instruction manuals, and cards with the local clinic's information. In her belly is a baby due next month — at eighth months pregnant, Veronica has spent most of June walking through rural communities, knocking on doors and encouraging people to test themselves. #Malawi #psiimpact #unitaid #hiv #health #badbitchalert

A photo posted by Jill Filipovic (@jillfilipovic) on

“Universal truths are rare, but at least in my experience, one of them is that community health workers (midwives, nurses, peer educators) are some of the baddest broads in any country.” —@jillfilipovic

Between now and 2017, the STAR project will distribute nearly 750,000 HIV self-test kits in sub-Saharan Africa. Supporting a comprehensive approach that includes HIV self-testing gets people on treatment faster so we can reach the UN’s 90/90/90 goal. When we remove the barriers stopping people from knowing their HIV status, we help fast track treatment, reduce stigma and enable people to live healthy and productive lives.