Trial reportBMJ global health2021
Effect of door-to-door distribution of HIV self-testing kits on HIV testing and antiretroviral therapy initiation: a cluster randomised trial in Malawi.
Trial report in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02718274 (HIV Self-testing Africa), which is not on this map. Cited by 10 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
HIV Self-testing Africa (STAR) Malawi: General Population - A Cluster Randomized Trial of Providing HIV and Self-testing Kits Through Community-based Distribution Agents
Who cites it
10 citing papers in PubMed, 19 citations in OpenAlex.
- A process evaluation of community-led distribution of HIV self-testing kits in rural communities in Zimbabwe.Health policy and planning · 2026Trial
- HIV testing and linkage to ART following secondary distribution of HIV self-test kits to male partners of women living with HIV: a pilot randomized control trial in Mpumalanga, South Africa.Journal of the International AIDS Society · 2022Trial
- Inequalities in the provision of rapid HIV testing in primary health care: ecological study, Paraná, 2013-2023.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2026Article
- Urine-based HIV-1 self-testing in China: A cross-sectional diagnostic accuracy and usability study.Scientific reports · 2025Article
- Do community-level factors play a role in HIV self-testing uptake, linkage to services and HIV-related outcomes? A mixed methods study of community-led HIV self-testing in rural Zimbabwe.PLOS global public health · 2025Article
- Preventing Unintended Pregnancies and HIV Through Self-Care Interventions in East and Southern Africa: Findings From a Structured Review.Public health reviews · 2025Review
- HIV self-testing in India: implementation and qualitative evaluation of a web-based programme with virtual counsellor support.Journal of the International AIDS Society · 2024Article
- Measuring the performance of HIV self-testing at private pharmacies in Kenya: a cross-sectional study.Journal of the International AIDS Society · 2023Article
- Highlighting and addressing barriers to widespread adaptation of HIV self-testing in the United States.Expert review of molecular diagnostics · 2023Review
- Impact of active case-finding for tuberculosis on case-notifications in Blantyre, Malawi: A community-based cluster-randomised trial (SCALE).PLOS global public health · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 5 institutions in 5 countries.
Funding
Abstract
introductionReaching high coverage of HIV testing remains essential for HIV diagnosis, treatment and prevention. We evaluated the effectiveness and safety of door-to-door distribution of HIV self-testing (HIVST) kits in rural Malawi.
methodsThis cluster randomised trial, conducted between September 2016 and January 2018, used restricted 1:1 randomisation to allocate 22 health facilities and their defined areas to door-to-door HIVST alongside the standard of care (SOC) or the SOC alone. The study population included residents (≥16 years). HIVST kits were provided door-to-door by community-based distribution agents (CBDAs) for at least 12 months. The primary outcome was recent HIV testing (in the last 12 months) measured through an endline survey. Secondary outcomes were lifetime HIV testing and cumulative 16-month antiretroviral therapy (ART) initiations, which were captured at health facilities. Social harms were reported through community reporting systems. Analysis compared cluster-level outcomes by arm.
resultsOverall, 203 CBDAs distributed 273 729 HIVST kits. The endline survey included 2582 participants in 11 HIVST clusters and 2908 participants in 11 SOC clusters. Recent testing was higher in the HIVST arm (68.5%, 1768/2582) than the SOC arm (48.9%, 1422/2908), with adjusted risk difference (RD) of 16.1% (95% CI 6.5% to 25.7%). Lifetime testing was also higher in the HIVST arm (86.9%, 2243/2582) compared with the SOC arm (78.5%, 2283/2908; adjusted RD 6.3%, 95% CI 2.3% to 10.3%). Differences were most pronounced for adolescents aged 16-19 years (adjusted RD 18.6%, 95% CI 7.3% to 29.9%) and men (adjusted RD 10.2%, 95% CI 3.1% to 17.2%). Cumulative incidence of ART initiation was 1187.2 and 909.0 per 100 000 population in the HIVST and SOC arms, respectively (adjusted RD 309.1, 95% CI -95.5 to 713.7). Self-reported HIVST use was 42.5% (1097/2582), with minimal social harms reported.
conclusionDoor-to-door HIVST increased recent and lifetime testing at population level and showed high safety, underscoring potential for HIVST to contribute to HIV elimination goals in priority settings. TRIAL REGISTRATION NUMBER: NCT02718274.
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