Arguments about HST took on a particular meaning depending on whether they were being discussed in the context of resource-rich or resource-limited settings. HST in resource-rich settings was seen as less problematic because it was assumed that individuals would be able to pay for the test, do the test, and experience the testing process in a context free from coercion or abuse [
30]. It was also the position of many authors that HST was less challenging in resource-rich settings because existing systems ensure proper regulation, access to health care, and protection from abuse [
17,
30]. In contrast, HST in resource-limited settings was considered to be more problematic because of numerous issues related to the test itself, namely its cost, accuracy, user-friendliness, and stability in warmer climates, the testing process which requires access to a confirmation test, and the infrastructures needed for regulation, health care and legal protections [
15,
17,
30,
32]. In resource-limited settings, the individual doing the test was often seen as more vulnerable, less autonomous, less able to negotiate, and less able to cope with results [
17]. That individual was also considered to be less likely to access the necessary treatment and care following a positive test result [
17,
32]. Overall, there was a clear divide between arguments about resource-rich and resource-limited settings, with resource-rich settings being seen as more conducive to HST. In our view, more research is necessary to move beyond assumptions about differences between these settings, and to specify the nature of this divide.