Indravudh PP, Fielding K, Kumwenda MK, et al. - Researchers undertook this cluster-randomised trial to assess the effect, safety, as well as expenses of community-led delivery of HIV self-testing (HIVST), intending to increase HIV testing in underserved subgroups and stimulate demand for antiretroviral therapy (ART). Thirty group village head clusters in Mangochi district, Malawi, were assigned, using restricted randomisation (1:1), to the community-led HIVST intervention in addition to the standard of care (SOC) or the SOC alone. In the community-led HIVST arm, there was higher lifetime HIV testing among adolescents, compared with the SOC arm, particularly among 15 to 17 year olds and boys. Also, a higher recent testing among older adults was seen in the community-led HIVST arm vs the SOC arm. Post hoc analysis revealed higher ART initiations in the 3-month post-intervention period in the community-led HIVST arm vs the SOC arm. Overall, findings demonstrate the effectiveness, safety, as well as affordability of community-led HIVST, with population impact and coverage rapidly realised at low cost. This strategy not only could allow HIV testing in high HIV prevalence settings but also exhibits potential for economies of scale and scope.