(P343) Mapping the South African e-Health service provider landscape for self-testing or self-sampling of sexually transmitted infection screening services

Background: In low-middle income countries (LMICs), such as South Africa, there is an urgent need to strengthen reproductive health care (RHC) services, and improve testing for sexually transmitted infections (STIs). Self-testing, self-sampling and e-Health platforms are potential affordable, accessible tools to achieve this and require further exploration. We have recently reviewed programmatic, ethical and economic considerations for implementations of self-testing/self-sampling point-of-care tests for STIs, including HIV, in the context of LMICs. Despite demonstrable efficacy, many available tests are not currently available in LMICs, including South Africa, and the regulatory framework to oversee these need to be developed. Here, we aimed to evaluate online self-testing and self-sampling service providers available in South Africa, as a mapping exercise to support development of national regulatory guidelines.



Methods: South African e-Health providers of STI tests (including both self-sampling and self-testing) were identified by searching Google (Nov 2022 to Jan 2023). Information on tests and associated services were collected from various websites, with further information obtained from providers via an online survey. This information was compared with South African Health Products Regulatory Authority (SAHPRA) and Health Professions Council of South Africa (HPCSA) standards for existing diagnostics and STI management.



Results: Thirty-four individual tests were identified, of which 30 were self-tests and four were self-sampling tests, available from nine unique service providers (Table 1). These included tests for HIV (8/34), syphilis (6/34), herpes simplex virus (HSV) (5/34), Chlamydia trachomatis (4/34), Neisseria gonorrhoeae (4/34), Hepatitis B (2/34), Hepatitis C (3/34) and 2 multiplexed tests that included Trichomonas vaginalis, C. trachomatis and N. gonorrhoeae. Most were either antigen-based (12/34) or antibody-based rapid tests (13/34), and required blood (14/34). Only 5/34 required urogenital sampling, while 11/34 did not state the sample type required. Of the 34 tests, 56% were manufactured in South Africa, with the mean cost per service being 20 United States Dollars (range: 1-62 USD).



Conclusion: e-Health and self-testing for STIs are available in South Africa and offer an important approach to improving care. This exercise will aid national policymakers in drafting guidelines for management and regulation of STI self-tests and e-Health providers in South Africa.