Development of an HIV self-testing service delivery system in four pilot provinces of Thailand

Abstract

In 2023, an estimated 9% of people living with HIV (PLHIV) in Thailand remained unaware of their HIV status. Although early diagnosis through HIV testing facilitates timely access to prevention and treatment services and reduces transmission, barriers such as concerns about confidentiality breaches and social stigma continue to limit uptake. To address these challenges, the World Health Organization (WHO) recommends HIV self-testing (HIVST) as a safe and effective strategy to expand testing coverage. In 2022, Thailand adopted HIVST as part of the national HIV prevention and control strategy in line with a resolution of the National AIDS Committee. This descriptive study aimed to summarize the implementation approaches and challenges of HIVST services in Thailand. Data were collected from a learning exchange conducted in four provinces, each representing one of Thailand’s regions, selected based on predetermined criteria.Additional data were obtained from the HIVST service platform (https://hivsst.ddc.moph.go.th) between February and September 2024. The findings showed that HIVST services were delivered through healthcare facilities and community-based settings, in collaboration with civil society organizations and the private sector. Implementation included the development of care and referral networks and utilizing multiple communication channels for outreach. Key challenges identified were a lack of confidence in self-testing, privacy concerns, limited access to digital technology, and the financial burden of procuring test kits. Among individuals who received HIVST kits, 65.9% reported their test results, and 0.55% testing positive. The study recommends expanding communication strategies and strengthening integrated service models, both online and facility-based, to improve access to prevention, testing, and care services, particularly among populations at higher risk of HIV infection.