Home HIV tests could be the key to reducing spread of AIDS Home tests reduce the stigma associated with going for screening, meaning people are more likely to get tested Self-tests can be carried out using saliva samples Experts believe self-testing might be the key to reducing the spread of HIV Making self-testing for HIV widely available could be the answer to reducing the spread of AIDS, claim experts. A major new review of the evidence suggests that self-testing reduces much of the stigma and fear attached to the disease and could help slow its transmission. Currently, screening is often not taken up because of fear and stigma associated, reports PLoS Medicine. Dr Nitika Pant Pai, of McGill University in Canada, said: "Thirty years into the HIV epidemic, there is no vaccine in sight. Treatment as a prevention strategy has been known to work, but uptake of HIV screening seems to be limited by a societal problem - HIV stigma and perceived discrimination. She said that access to an HIV self-testing, linked to counselling services, would help expand access to screening and reduce prejudice and negative attitudes around HIV testing. Self-tests are performed on fluid samples from the mouth in the privacy of the home, and can provide results within 20 minutes. A positive result, however, does require confirmation at a medical clinic. Dr Pant Pai and her colleagues looked at the global evidence on self-testing strategies They examined 21 worldwide studies and found that two distinct self-testing strategies have been tried - supervised self-testing (self-testing and counselling aided by a health-care professional), and unsupervised self-testing (self-testing performed without any help but with counselling available by phone or internet). Acceptability was found to be very high for both self-testing strategies, and the evidence suggested that people preferred self-testing to facility-based testing and oral self-testing to blood-based self-testing. Dr Pant Pai said: "The preference was largely driven by the fact the oral self-tests are non-invasive, convenient, easy to swab and do not involve a finger stick or blood from your arm for a preliminary screen. A lot of people also wanted to take the oral self-test home to test their partners. Self-tests are thought to be beneficial because they allow people to be tested for HIV without the stigma of attending a screening. Image shows a conceptual view of HIV in the blood stream Dr Pant Pai and colleagues are now urging policy makers everywhere to look at the proven results of supervised and unsupervised self-testing, and to think how best to put these strategies into practice in their own countries. She said: "We have, as a society, made great progress with biomedical tools, drugs and strategies, but we haven't conquered HIV-related stigma and perceived discrimination. The time is now right to tailor strategies to suit the preferences and lifestyles of patients with a view to expanding access.