Oral fluid versus blood in HIV self-testing: A step towards "95-95-95" targets of the UNAIDS?

Oral fluid versus blood in HIV self-testing: A step towards "95-95-95" targets of the UNAIDS?

Balakrishnan, Pachamuthu; Vignesh, Ramachandran; Ganesh, Pitchaipillai Sankar; Shanmugam, Saravanan; Kannan, Iyanar; Sivamalar, Sathasivam; Raju, Sivadoss; Velu, Vijayakumar; Shankar, Esaki M; Sucharitha, Sree T
Diagnostic microbiology and infectious disease 2025 Vol. 113 pp. 116867
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balakrishnan2025oral

Abstract

The population of HIV-infected individuals who are not aware of their HIV status or who do not usually have access to HIV services should be reached by the newer strategies. The WHO's guideline on HIV self-testing (HIV-ST) was based on a boost in the number of tests administered in randomized clinical trials, including those carried out among the general population in regions with a high HIV burden. Therefore, HIV-ST offers tremendous potential as a strategy to enhance testing frequency and improve access to HIV testing among key high-risk populations and their partners. Recent studies have documented that HIV-ST with oral fluid is perceived as a more convenient and also preferred option than using the finger prick blood-based testing due to "fear of prick", and have also reported of user's error with finger prick blood-based tests increasing than oral fluid-based test. The major benefit of oral fluid-based HIV-ST is that it makes it easier for first-time users to access testing and is more likely to increase testing frequency among key high-risk populations. The current review summarizes the pros and cons of the HIV-ST devices.

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