HIV Self Testing
HIV self testing means that a person can order or purchase their own HIV test, do the test themselves, and get their results right away without having to go to a clinic or doctor’s office (similar to a home pregnancy test). The self test is different from other HIV tests available on the market for public use, such as mail-order tests which require a person to send a self-collected sample of their blood to a lab for testing.
The AIDS and Hepatitis C Programs of the Ontario Ministry of Health released a Bulletin addressing frequently asked questions about HIV self testing for health care community providers.
There is currently only one approved HIV self-test device available in Canada. The HIV self/home-test (INSTI HIV Self Test®) made by a Canadian company, bioLytical Laboratories was approved by Health Canada on November 3, 2020. See the announcement from bioLytical Laboratories. The INSTI HIV self test has an accuracy of 99.5% The INSTI self test is available for purchase directly from bioLytical.
HIV self tests and their accuracy
HIV self testing is quick, simple, and accurate. Self tests can be done in less than 10 minutes!
HIV self-tests, similar to the HIV point-of-care test, is considered a screening test. This means that reactive (positive) self test results must be confirmed by a lab-based test.
HIV self testing and the HIV window period
When a person is newly infected with HIV, there is a window period when HIV cannot be detected in the blood. The accuracy of the HIV self test depends on the amount of time that has passed since exposure to HIV.
If a person has had a high-risk exposure to HIV, either through sexual activity or substance use, it is recommended to offer laboratory-based HIV diagnostic serology testing at three weeks, if negative, again at six weeks, if negative, again at three months (3-6-3). If a person chooses to test in the window period using a self test, they can test at three weeks after exposure, if negative, again at six weeks, if negative, again at three months (3-6-3).
HIV self testing in Ontario
HIV self testing is available through the manufacturer, partnerships with community organizations, pharmacies, and province-wide research programs.
- GetaKit: Free, mail-out HIV self test kits are available through www.getakit.ca. GetaKit is working with community organizations to provide self testing kits to people across Ontario, and ensure local linkage to care and prevention services if necessary. Participants can identify their nearest GetaKit partner location on the GetaKit website, register online, and order a test kit to be delivered to their home or a pickup location. Once participants have completed the self test, they are encouraged to report their results online, or contact their partner organization for support. GetaKit is co-led by the University of Ottawa and the Ontario HIV Treatment Network (OHTN). Learn more about the GetaKit project and order a kit here.
- I’m Ready: Free, mail-out HIV self test kits are available through www.readytoknow.ca. The I’m Ready research project is a national research project examining HIV self testing in Canada. Participants can register with the I’m Ready, Test app, and order up to three HIV self testing kits to their home or a pickup location. Once participants have completed the self test, they can anonymously report their results on the app. Participants can also speak with peer navigators to receive support through the I’m Ready, Talk telehealth service. I’m Ready is an initiative of REACH Nexus and the MAP Centre for Urban Health Solutions at St. Michael’s Hospital. Learn more about the I’m Ready program here.
- bioLytical: The INSTI self test is available for purchase directly from the manufacturer.
- Pharmacies and Retailers: HIV self tests are available for purchase at select pharmacies. To learn if HIV self tests are available for purchase, contact your local pharmacy.
Prevention and support referrals
Please use the resources listed on the prevention and support referrals page of this website, to assist clients using the self test to find support and follow-up (confirmatory) testing, as needed. Family doctors, or HIV testing sites (public health units, community health centres) can do follow-up HIV testing and provide HIV treatment and care or linkage to treatment and care. The Sexual Health Infoline Ontario can assist in finding confirmatory testing sites.
Evidence on the use of self testing
HIV self testing has been found to be acceptable, and may be able to effectively reach people who have not been previously reached by HIV testing programs. This is particularly true when self testing programs are targeted for members of priority populations at high risk for HIV.
The OHTN has produced multiple rapid responses summarizing the research evidence from other jurisdictions around the application of HIV self testing, including:
- Free HIV self-testing: Best practices, positivity rates, and associated costs (Aug 17, 2020)
- HIV self-testing in high-income settings: Acceptability, potential benefits and harms, issues related to linkage to care, interventions to increase HIV self-testing (Nov 28, 2019)
- The risk of coercion in the context of HIV self-testing (Sept 24, 2019)
- The acceptability and use of HIV self-testing among men who have sex with men in high-income countries (Feb 27, 2017)
Additional OHTN rapid responses on related testing topics, are available here.