Towards Ending AIDS: The Additional Role of HIV Self-Testing in Thailand

Cheewanan Lertpiriyasuwat; Patsaya Mookleemas; Naparat Pattarapayoon; Darinda Rosa; Viroj Tangcharoensathien

doi:10.9745/GHSP-D-24-00156

Key Messages

In 2015, Thailand introduced HIV self-testing (HST) into its national HIV program, following World Health Organization recommendations for safe, accurate, and accessible testing for individuals who may avoid health care facilities for fear of stigma. HST aims to increase awareness of HIV status and prompt treatment across the population.
In 2023, the National Health Security Board included HST in the universal health coverage package, offering it free of charge with no annual limits on the number of tests.
Program managers provided comprehensive information on HST, including how to interpret results and next steps.
The National Health Security Office negotiated for the lowest price with assured quality and the national HIV program established a monitoring system and conducted impact assessment to enhance program performance.

Abstract

Background:

In 2022, 10% of an estimated 560,000 people living with HIV in Thailand were unaware of their HIV status. A well-established HIV program is a solid platform for integrating HIV self-testing (HST) as part of efforts to end AIDS. We analyzed how HST was integrated into the national HIV program and became a benefit package.

Policy Adoption of HST:

In 2015, the National AIDS Prevention and Alleviation Committee included HST as a strategy to end HIV/AIDS by 2030. This led to collaboration between the Department of Disease Control (DDC), Food and Drug Administration (FDA), and partner networks, including civil society organizations, to amend policy regulations, allowing HIV testing outside health care facilities and facilitating HST registration. By 2024, 4 HST commercial products were registered by the Thai FDA.

Program Pilots:

In 2020, the DDC launched pilot programs distributing HST kits through private pharmacies in Bangkok and online platforms. Preliminary findings showed feasibility in reaching key populations and adolescents. In 2023, HST was included in the Universal Health Coverage benefit package, providing free access to all citizens. Guidelines, e-learning, public awareness campaigns, and a reimbursement system of HST were developed and implemented. By September 2024, over 166,000 users had received HST kits.

Lessons Learned:

Leadership, scientific evidence, feasibility testing through pilots, regulatory adjustments, licensing, price negotiations by the National Health Security Office, and stakeholder and community engagement were key to the program’s success. A nationwide distribution network through public and private health care facilities, including pharmacies, was a key enabling factor for HST delivery.

Conclusions:

HST is an additional intervention to increase awareness of HIV status and a key component in Thailand’s effort to end HIV/AIDS.

Received: June 17, 2024.
Accepted: November 13, 2024.
Published: December 20, 2024.

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