Self-test kit distribution
The goal of HIV self-test kit distribution should be to enhance the accessibility of self-testing by implementing distribution methods informed by your community and that are practical for your organization. The distribution of HIV self-test kits can be integrated into existing services, or new ways of distributing self-test kits can be developed. Kit distribution methods should be responsive to the needs of communities and consider the unique barriers that exist. Strategies should aim to be as low-barrier as possible, bringing tests to where people are and encouraging approaches such as secondary distribution to extend reach. There is no one-size-fits-all approach to self-test kit distribution, and organizations may consider using multiple approaches to reach different community members at different times. Regardless of the approach, self-test kit distribution is an opportunity to engage with clients, assess their health and social support wants and needs, normalize testing and help them to connect with services.
“Relationships built through distributing self-test kits” – Dialogue participant
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The following best-practice recommendations outline strategies to consider when developing approaches to distribute HIV self-test kits. Specific practice-based recommendations for different distribution methods follow.
Practice-based recommendations:
1. Consider the various ways that self-test kits could be distributed. Ensure that the distribution method(s) your organization chooses to implement meet(s) the needs of your community and is (are) within your organization’s capacity.
2. Taking into consideration your organizational capacity, consider using multiple distribution methods both within and outside of your organization.
3. Integrate self-testing kit distribution into existing programs and services (e.g., workshops, naloxone training, needle and condom distribution) through careful planning and coordination to maximize efficiency and minimize disruption to ongoing activities.
4. Make self-test kits visible and easily accessible in-office (e.g., reception desk), allowing individuals to pick them up during appointments or visits.
5. Consider ways to distribute self-test kits discreetly (e.g., unbranded gift bags, washrooms).
6. Make your distribution strategies as low-barrier as possible for the communities that you are aiming to reach.
7. Make self-test kits available in more locations and bring tests to where people are both within and outside of your organization (e.g., drop-in programs that distribute food, community-based shelters).
8. Encourage and support people to take more tests than they need to distribute to friends, family or peers (i.e., secondary distribution). This reaches people who are hesitant to access healthcare and social services themselves.
9. Consider exploring innovative distribution methods, such as vending machines, to increase the accessibility and visibility of self-test kits.
10. Consider whether your organization will allow people to test on-site. If you allow on-site testing, provide private, comfortable spaces for people to do the test, with optional support from trained staff. Establish clear policies and boundaries for these testing procedures.
11. Consider providing real-time support (e.g., phone or text support) to people who are testing off-site. This support should be offered in a confidential and accessible manner.
12. Consider the feasibility of offering HIV confirmatory testing through each distribution mechanism your organization uses. This may be particularly relevant in rural communities where access to confirmatory testing is limited.
13. Consider distributing HIV self-test kits alongside other resources that promote health and well-being (e.g., condoms, lubricants, water bottles, hygiene kits and harm reduction supplies). Offering a variety of items gives people a discreet way to access kits and gives you an opportunity to provide more resources to clients.
14. Consider including informative materials in a package along with the self-test kit. This can include a pamphlet about how the self-test works, local information about where to go for confirmatory testing and information on HIV prevention.
15. Develop and provide inclusive and affirming spaces for open discussions around HIV self-testing.
16. Ensure distribution methods are designed with insights from community leaders, including Elders, to ensure delivery methods honour and reflect community values and culture.