Scaling Up HIV Self‐Testing in Africa: Insights From National Programmatic Data in Eight Countries

INTRODUCTION: Evidence from routine, national programme data on HIV self-testing (HIVST) scale-up is limited. This study examines HIVST scale-up in eight African countries, describing how HIVST has been integrated into testing strategies and how testing coverage, test positivity, and linkage to antiretroviral therapy (ART) have evolved. METHODS: We conducted a retrospective descriptive analysis of national programme data from January 2019 to December 2023 across Kenya, Lesotho, Malawi, Mozambique, South Africa, Tanzania, Uganda and Zimbabwe. Data were disaggregated by quarter and subnational district. Indicators included HIVST kits distributed, conventional testing volumes, new HIV diagnoses and new ART initiations. We derived testing rates, testing positivity, ART linkage, and stability of HIVST distribution by district and over time. RESULTS: HIVST scale-up varied across countries. By the most recent quarter, HIVST accounted for 63% of total testing in Lesotho, 19%-25% in Malawi and Zimbabwe, but