Extensive review of evidence on linkage to care following HIVST positive result among men has informed this proposal. We conducted a systematic review to synthesize available published evidence on linkage to HIV care following HIVST positive result among men in sub-Saharan Africa. Results showed that linkage to care following HIVST positive result is subject to several barriers, including financial constraints due to travelling costs, potential long waiting hours at the health care clinics, stigma, discrimination, and privacy concerns associated with attending a health care clinic setting. For example, studies conducted in Zambia, Uganda, Malawi and South Africa indicated that most poor men, even when they may intend to confirm HIVST results and be initiated on ART at the clinic, if tested HIV positive, may not be able to do so due to financial constraints or travelling costs [
26,
27,
29,
39]. Rates of men seeking HIVST confirmation and subsequent linkage to care following HIVST positive result were inconsistent. In South Africa, 72% of men with reactive HIVSTs received a confirmatory test, and 95% who were confirmed HIV positive were subsequently linked to HIV care and started on treatment, when financial incentives were included [
25]. However, without the incentives, 68% of men who tested HIVST positive were linked to care and started on treatment [
25]. In Malawi, secondary distribution of HIVST kits to male partners by women attending antenatal care showed increased linkage to HIV care post HIVST positive, especially when conditional financial incentives were included [
28,
29]. While linkage to HIV care after HIVST has been high in some studies, in a study conducted in Malawi aimed at estimating a timely linkage into confirmatory testing and HIV care following HIVST, the authors reported linkage to care after HIVST at 56.3% [
17]. Similar findings were observed in Kenya, where 65% of participants who were newly diagnosed with HIV sought confirmatory testing, and 58% of those were linked to care within the three month follow up [
40]. A study conducted in South Africa showed that linkage to confirmatory testing (18.1%, 116/640) as well as HIV care (16.0%, 12/75) after unsupervised HIVST was relatively low, despite telephonic reminders and home visits [
27]. Lower rates of linkage to care after HIVST were also presented in Kenya, where only 25% (2/8) of men who were tested positive using the HIVST, went for confirmatory testing, and subsequently linked to HIV care [
41]. Similarly, only 23% of men who were HIVST positive in Uganda were linked to HIV care in the intervention arm compared with 66.7% in the control arm [
26]. Importantly, reports on linkage to care following HIVST reactive result have mostly focused on male partners of pregnant women attending antenatal clinic. Some studies included financial incentives to motivate those who were HIVST positive to be linked to HIV care. Given the persistent barriers deterring men from accessing HIV services in health care setting, and the inconsistency of linkage to care rates, these suggest the importance of community-based ART initiation following HIVST reactive result.