Impact of assisted HIV self-testing on case-finding rate and positive HIV diagnoses in Burundi: A province-level difference-in-difference analysis.

This article evaluates the impact of ICAP-Columbia University's Reaching Impact, Saturation and Epidemic Control (RISE) program’s healthcare-worker-assisted HIV self-testing (aHIVST) on HIV case finding in "hard-to-reach" general population groups across targeted provinces in Burundi from 2020 to 2023. Using a difference-in-difference analysis comparing provinces with more mature versus less mature aHIVST scale-up, the study found no statistically significant changes in the number of persons testing HIV-positive (PTP) or the HIV case finding rate (CFR) after the scale-up. Subgroup analyses by age and sex also showed no significant differences, and declining trends in PTP and CFR persisted post-scale-up. Following these findings, program implementers adjusted strategies to better target populations at increased risk, highlighting the role of routine monitoring and evaluation in informing HIV testing interventions.