Diverse group of South African men using HIV self-test kits.

HIV Self-Testing: Can South African Men Handle It?

Beau Callahan in Health & Wellness December 2025 • 5 min read.

"New research explores whether oral fluid and fingerstick HIV self-tests are usable by South African men, a key population in the fight against HIV."

In South Africa, where the HIV-positive population is among the highest in the world, traditional HIV testing methods often fall short, particularly for men. Men test at significantly lower rates than women, creating a critical gap in efforts to curb the spread of the virus. This disparity is further exacerbated among men who have sex with men (MSM), a high-risk group often facing additional barriers to accessing healthcare.

HIV self-testing (HIVST) emerges as a promising alternative, potentially increasing testing uptake and facilitating earlier diagnosis and treatment. But how usable are these tests for the populations who need them most? A recent study in South Africa dives into this question, examining the ability of MSM to correctly use oral fluid and fingerstick HIV self-tests.

This article explores the findings of this research, revealing the challenges and successes of HIV self-testing among South African MSM and highlighting the crucial role of accessible instructions and targeted support.

Decoding HIV Self-Testing Usability: What the Research Reveals

Diverse group of South African men using HIV self-test kits.

The study, conducted in Mpumalanga, South Africa, involved MSM with varying degrees of experience with HIV self-testing. Researchers assessed the usability of both oral fluid (OF) and fingerstick (FS) HIVST kits across three phases: Phase I: HIVST-naïve MSM received a brief demonstration before conducting observed self-tests.

Phase II & III: MSM with prior HIVST experience chose a test kit to use under observation, with access to both written and video instructions.

Researchers tracked user errors, assessed ease of test use, and identified factors influencing correct usage. The results offer a nuanced picture of the potential and the pitfalls of HIV self-testing. Oral Fluid Tests: Participants generally performed well with the oral fluid tests, with observers consistently rating them as capable of testing alone, despite some errors. Observers noted the errors may impact test result but were universally confident that users would be able to conduct the OF test correctly in an unobserved setting. The research team noted that frequency of errors did not decrease over study phases. Reported self testing experience was high for ease/difficulty in collecting samples and conducting tests, with all participants reporting in phase 2 that they would trust the results. Participants were confident in their ability to use the OF test: 87.5% in phase I and 100% in phases II-III felt very confident they used the OraQuick test correctly. Fingerstick Tests: Fingerstick tests presented more challenges. Observers noted frequent errors, particularly related to blood collection and delivery. Although error rates decreased with increased HIVST experience, observer concerns about the participants' ability to test alone remained constant. Participants felt positive about fingerstick tests in terms of reported self testing experience for collecting samples and conducting tests, with all participants trusting results.

The Future of HIV Self-Testing: Accessible Instructions are Key

The study underscores the importance of accessible and user-friendly instructions, especially for fingerstick HIV self-tests. While the oral fluid tests proved relatively easy to use, the fingerstick tests required more careful attention to detail and technique.

The research also highlights the potential of increased experience and exposure to HIVST to improve usability. As participants became more familiar with the process, they made fewer errors and reported greater ease and confidence in their ability to conduct the tests.

HIV self-testing holds significant promise for increasing HIV testing rates and promoting earlier diagnosis and treatment among key populations like MSM in South Africa. By addressing the challenges in usability and ensuring access to clear and effective instructions, we can unlock the full potential of this innovative approach to HIV prevention.

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This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1371/journal.pone.0206849, Alternate LINK

Title: Ability To Use Oral Fluid And Fingerstick Hiv Self-Testing (Hivst) Among South African Msm

Subject: Multidisciplinary

Journal: PLOS ONE

Publisher: Public Library of Science (PLoS)

Authors: Sheri A. Lippman, Hailey J. Gilmore, Tim Lane, Oscar Radebe, Yea-Hung Chen, Nkuli Mlotshwa, Kabelo Maleke, Albert E. Manyuchi, James Mcintyre

Published: 2018-11-08

Everything You Need To Know

What is HIV self-testing, and why is it important?

HIV self-testing (HIVST) involves individuals using self-tests, like the oral fluid and fingerstick tests, to determine their HIV status. It's significant because it offers a potential solution to increase HIV testing rates, especially among men in South Africa where traditional methods fall short. The implications are that wider access to HIVST could lead to earlier diagnosis and treatment, ultimately helping curb the spread of the virus.

What are the different types of HIV self-tests mentioned, and why is the distinction important?

The research specifically studied oral fluid (OF) and fingerstick (FS) HIV self-tests. The oral fluid tests involve collecting a sample of oral fluid, while the fingerstick tests require a blood sample. The importance lies in understanding the usability of different methods. Implications of this is that one method may be easier to use than another and therefore produce less user error and more accurate results. The study underscores the importance of accessible and user-friendly instructions, especially for fingerstick HIV self-tests.

Where was the study conducted, and why is the location significant?

The study was conducted in Mpumalanga, South Africa. Its significance lies in focusing on a region with a high HIV-positive population and a critical gap in testing rates among men, particularly those who have sex with men (MSM). The implications of this is that results from this research can be tailored to specific regions with unique needs. Results revealed the challenges and successes of HIV self-testing among South African MSM and highlighting the crucial role of accessible instructions and targeted support.

What aspects of the HIV self-tests did the research evaluate, and why is that important?

The research evaluated the usability of HIV self-tests, tracking user errors, assessing ease of use, and identifying factors influencing correct usage. This is important because it reveals how well the tests are actually used by the target population. The implications are that if the tests are not easy to use, there will be a higher error rate and therefore a lower chance of an accurate result and a reduction in testing rates and diagnosis.

What were the main findings regarding the usability of the oral fluid and fingerstick tests, and what are the implications?

The study found that oral fluid tests were generally easier to use, with participants reporting high confidence in their ability to use them correctly. Fingerstick tests presented more challenges, with more errors. These findings highlight the importance of accessible instructions, as the method of delivery may impact the user's ability to use the test correctly. The implications suggest that the ease of use influences the likelihood of accurate results and the potential for successful self-testing programs. These results can be used to improve test design or instruction delivery to improve usability.