Table 1.

Summary of models of distribution

Model	Target population	Distribution model description	Rationale
1. Community based (mainly door‐to‐door)	Rural populations: esp. adult men, young people (16 to 24 years) unable to access conventional testing services	HIVST kits offered at household by CBD for clients to test on own or with assistance. Referral facilitation by CBD for confirmatory testing, ART, and prevention services	Increases testing in populations who would otherwise not seek testing services, rapidly and drastically increases testing coverage
2. HIVST integrated into Mobile Services or HIVST fixed sites	High risk adults, adult men (>25 years), adolescents 16 to 24, esp. girls & young women	Distribution at community hotspots e.g. shopping centres, taxi ranks, urban and rural hot‐spots (bus or truck stops, growth points). Confirmatory testing and in some cases ART on site	Test‐for‐ triage: fast track pre‐screening, triaging out those who self‐test HIV negative unless confirmatory testing desired. Providers shift in attention: to those who require more attention and increasing: – index testing and assisted partner notification, confirmative testing of HIV positives, initiation of ART
		People can test themselves in a cubicle at the distribution point or HTS Clinic (with assistance available) or take kit home	Increase in demand for HTS, if mobile services or fixed HTS clinic services are promoted as outlets for HIVST kits
	Sexual partners of HIV+ index diagnosed at HTS (secondary distribution)	HIVST kit offered to HIV+ index to take to sexual partner(s). Follow up with index or partner for confirmative testing	Increases likelihood of sexual partner to take up HIV testing. Based on evidence high proportion of sexual partners of positive indexes are testing positive
3. HIVST offered at male dominated workplaces	High risk adults, adult men (>20 years)	HIVST kits are offered to employees at male dominated workplaces after buy‐in and agreement has been obtained from the employer. Employees can choose to perform HIVST in a private space provided at the workplace where assistance is available or take the HIVST kit home	Increases testing in populations who would otherwise not seek testing services, rapidly and drastically increases testing coverage
4. Integrated with public sector facility	Patients accessing health care facilities in urban and rural areas	Facility‐based counsellors and Health care workers are directly promoting HIVST at entry points of the health delivery system, e.g. outpatients, in‐patients	Test‐for‐triage approach and HTS clinic shift in attention (as above) Increases numbers tested, and coverage of more targeted provider‐initiated testing to maximize HIV diagnoses, ART initiation and prevention service uptake
	Sexual partners of HIV+ index diagnosed at HTS (secondary distribution)	HIVST kit offered to HIV+ index to take to sexual partner(s). Follow‐up with index or partner for confirmative testing	Increases likelihood of sexual partner to take up HIV testing. Based on evidence high proportion of sexual partners of positive indexes are testing positive
	Male partners of pregnant women accessing public sector maternity services (secondary distribution)	HIVST kit is offered to all pregnant women regardless of HIV status to take to male partner	Increases the opportunity of male sexual partners of pregnant women to access HIV testing services, and to be linked to care, treatment and prevention, dependant of status
5. Integration with VMMC Mobilization	Adult males, 20 and above, who are mobilized for VMMC services	HIVST is offered to adult males, who are mobilized for VMMC, to use at home before accessing VMMC services	Fear of a positive test result and fear of testing prevents adult males from taking up VMMC services
			Offering HIVST can reduce this barrier and increase motivation to take up VMMC