Resum

BACKGROUND: In Argentina, 17% of PLHIV do not know that they are infected; and HIV prevalence is high among key populations (KP) such as cisgender men who have sex with men (MSM) transgender women (TGW) and sex workers (SW). Implementation of HIV self-test in testing programs is recommended by the WHO. The aim of this study was to explore the acceptability and diagnostic performance of an HIV self-test in KP. METHODS: This is a pilot cross-sectional study, eligible individuals aged '¥18 years self-identified as transgender men(TGM), TGW, MSM and/or SW with unknown HIV status who attended the local community-based testing centers in 3 districts in Argentina were offered a finger-prick HIV self-test (SURE CHECK® HIV 1/2 Assay, Chembio Diagnostics), in addition to the standard POC HIV tests (Alere Determine® HIV-1/2). A survey was used to assess HIV infection risk and self-test acceptability. The study had the technical cooperation of the PAHO and was approved by local IRBs. Funding: National Ministry of Health. RESULTS: Recruitment was affected by COVID-19 pandemic. A total of 321 individuals with a median age of 29 years were included (66.4% cisgender men, 14.3% cisgender women, 14.3% TGW,2.2% TGM, 2.8% non-binary/other), 30% were SW. Global HIV prevalence was 3.7%; 22% of the study population had not been tested for HIV ever before. Concordance between HIV self-test and conventional POC test was 97.8%, acceptability among the participants was high(Table).The main advantages of the self-test mentioned by the participants included: privacy(42%), easiness(33%) and possibility to do it accompanied or alone(16%); 54% did not find any disadvantages and 91% would seek medical attention if the test was positive. CONCLUSIONS: In this study, a finger-prick HIV self-test was highly accepted by KP in a LMIC and showed good diagnostic performance. Implementing this strategy could significantly contribute to improve access to HIV diagnosis among KP (particularly hard-to-reach KP) and closing the gap towards UNAIDS 95-95-95 targets.