HIVST PRIORITY POPULATIONS. As stated before, HIVST is not intended as a replacement for conventional HIV testing, efforts should focus on populations who cannot access other forms of HIV testing. During an initial situational analysis before starting on program design, the populations missed by current testing programs should be identified, or segments of the population where HIV risk is particularly high and testing needs to be done frequently. This information should be used to define the target populations for HIVST and delineate groups according to how one intend to reach them with services. WHO and PEPFAR identify a number of populations as generally high priority for HIVST: • Adult men in high HIV-burden settings • Adolescents and young people (aged 15–24 years) in high HIV-burden settings • Couples and partners, including partners of people living with HIV (PLHIV) • Individuals with STIs • Individuals attending family planning services • Pregnant and postpartum women in high HIV burden settings • Men who have sex with men and their sexual partners • Transgender women and men and their sexual partners • People who inject drugs and their sexual partners • Sex workers and their sexual partners • XXXXX who are lost to follow up (LTFU) to facilitate re-entering treatment and care. These populations will be covered in greater detail in the implementation section of this operational guide. Additionally, there may be country-specific populations at high risk, targeted by the national government and the donors or that you identify in your research and situational analysis who could also benefit from HIVST. Prior to starting HIVST implementation, it is recommended that programs conduct a baseline assessment to identify which populations will most benefit from self-testing using existing routine indicators for HIV testing and linkage to prevention and treatment (refer to the WHO Consolidated Guidelines for Strategic Information in the Health Sector33 for specific information on these assessments. Properly understanding your target populations is critical for making decisions about selecting an appropriate combination of HIVST products and distribution models for your program that meets their needs, is adapted to population preferences and meets any legal or regulatory requirements for the country.
