KARACHI:With a commitment to reducing HIV mortality and introducing treatment to all, international organizations across the globe will observe the World AIDS Day on December 1, 2019.
The annual commemoration was the first initiated by the World Health Organization (WHO) in 1988 as a day to unite the world in the fight against HIV/AIDS.
Ahead of World AIDS Day, the WHO released consolidated guidelines on HIV testing services, which include new approaches to respond to “contemporary needs.” Under the new guidelines, the WHO encourages all countries to adopt a standard HIV testing strategy using 3 consecutive reactive tests to confirm a diagnosis. This is will replace the 2 consecutive test approach, which many countries rely on, and will help achieve maximum accuracy.
The new guidelines also recommend the use of self-tests. This is based on evidence that individuals who are at a higher risk for acquiring HIV who are not testing in clinical settings are more likely to undergo testing if they can self-test for HIV.
Additionally, the guidelines emphasize the importance of using social network-based HIV testing in order to reach individuals who are at high risk but do not have adequate access to HIV testing services. The WHO notes that when testing 99 contacts from social networks of 143 HIV-positive people in the Democratic Republic of Congo, 48% tested positive for HIV.
In order to build demand and increase uptake of HIV testing, digital communications including short messages and videos can be used. In Vietnam, this outreach method was used among 6500 individuals from key at-risk groups. In total, 80% were referred to testing and 95% complied. Among these at-risk individuals, 75% had never engaged in outreach services for HIV.
In relation to contemporary needs, the agency recommends using community efforts to deliver rapid testing where the laboratory-based method called “western blotting” is still in use. This is based off of evidence from Kyrgyzstan where HIV testing using the method typically took 4-6 weeks, but following policy changes, only takes 1-2 weeks and is more affordable.
Finally, the WHO recommends using HIV/syphilis dual rapid tests in antenatal care to eliminate mother-to-child transmission of both infections and reduce the rate of stillbirths worldwide.
“Saving lives from HIV starts with testing,” Rachel Baggaley, MD, MSc, WHO’s Team lead for HIV Testing, Prevention and Populations, said in the WHO’s statement. “These new recommendations can help countries to accelerate their progress and respond more effectively to the changing nature of their HIV epidemics.”