Assessment of the acceptability and detection rate of HIV self-testing in Nigeria: a systematic review and meta-analysis

HIV remains a major public health challenge in Nigeria, with significant gaps in testing coverage caused by stigma, limited healthcare access, and logistical issues, highlighting the need for enhanced HIV control efforts. HIV self-testing presents a promising solution to overcome these barriers; however, there is a lack of systematic review and meta-analysis on its effectiveness within Nigeria for evidence-based medicine decision.

To systematically assess the acceptability and detection rate of HIV self-testing in Nigeria.

Studies conducted in Nigeria on HIV self-testing with or without comparison to other HIV tests were included. The primary outcomes were the detection rate of new HIV cases and acceptability (uptake) rate for HIV self-testing. Electronic databases (PubMed/Medline, Web of Science, Scopus, CINAHL, and Cochrane Library) and Google Scholar were searched. Pooled estimates were calculated using a random-effects model. Heterogeneity was analyzed using the I² test, and risk of bias was assessed with the Hoy and colleagues’ scale. The PROSPERO registration number: CRD42023479752).

Eight studies, encompassing 7556 participants, met the inclusion criteria. The overall risk of bias was low. The detection rate of HIV self-testing for new HIV cases was 25.78% (95% CI 0.90–50.66, I²:100.0), acceptability (uptake) rate was 56.92% (95% CI: 26.54–87.30, I²:100.0), and repeat testing rate was 20.10% (95% CI − 11.44–51.65, I²:100.0).

The use of HIV self-testing test kits in Nigeria showed a high detection rate of new HIV cases, moderate acceptability, but low repeat testing rates. Larger, higher-quality studies are essential to explore the broader impact of HIV self-testing on reducing HIV incidence in Nigeria.