Factors associated with first-time HCV testing.

Hepatitis C virus self-testing (HCVST) has been shown to reach people who may not otherwise test. We conducted a cross-sectional survey to assess the effectiveness and costs of different HCVST distribution models among key populations (KPs) and people living with HIV (PLHIV) in Hanoi and Ho Chi Minh City, Vietnam, between September 2023 and April 2024. We engaged eight community-based organizations (CBOs) and 10 public and private clinics in offering HCVST using oral fluid-based HCV rapid antibody tests along with standard or provider-led HCV testing (HCVT). HCVST effectiveness was assessed by the proportion of first-time testers, HCV positivity yield, and linkage to care. Outcomes were stratified by distribution model (community, facility, online, secondary distribution) and compared to standard HCVT. Cost per HCV diagnosis was calculated in US dollars. Among 2,882 participants tested for HCV, 1,834 used HCVST and 1,048 used standard HCVT. HCVST users were more likely to be first-time testers compared to those opting for standard testing (67.6% vs. 59,1%; p