WHO/UNAIDS issue new HIV testing guidance

Accra, June 14, GNA - The World Health Organisation (WHO) in collaboration with UNAIDS have issued new guidance on Voluntary HIV testing and counselling in all health facilities throughout the world. The new guidance focuses on provider-initiated HIV testing and counselling as recommended by health care providers in health facilities.

The new WHO/UNIADS guideline was prepared in light of increasing evidence that provider-initiated testing and counselling could increase uptake of HIV testing, improve access to health services for people living with HIV and create new opportunities for HIV prevention. This was contained in a document by WHO and made available to the Ghana News Agency in Accra on Thursday.

It advised that all health care providers globally recommend HIV testing and counselling to people who were presented with conditions that might suggest underlying HIV.

The document noted that the new approach would increase access to the needed HIV treatment, care, support and prevention services. The document provided advice on how to prioritize implementation in different types of health facilities since WHO and UNAIDS had recognized resource and other constraints may prevent immediate implementation of the new method.

It said increase access to HIV testing and counselling was very essential to promoting earlier diagnosis of HIV infection, which could maximise the potential benefits of life extending treatment and care as well as allowing people with HIV to receive information and tools to prevent HIV transmission.

Until recently, the primary model for p roviding HIV testing and counselling had been client-initiated but uptake of client-initiated HIV testing and counselling had been limited by low coverage of services, fear of stigma, discrimination and the perception by many people that they were not at risk.

"Today, about 80 percent of the people living with HIV in low and middle-income countries do not know that they are HIV positive. Recent surveys in the Sub-Saharan Africa showed on the average, just 12 per cent of men and 10 per cent of women have been tested for HIV and receive their test results", the document said. It stated that current evidence also suggested that many opportunities to diagnose HIV in clinical settings were being missed in places with serious HIV epidemics adding, "While therefore expanded access to client-initiated HIV testing and counselling is still necessary, other approaches are also required if coverage of HIV testing and counselling is to increase and ultimately universal access to HIV prevention, treatment, care and support is to be achieved." It said the new guidance was an update of previous policy positions of WHO and UNIADS, which responded to a growing demand from countries for more detailed policy and operational advice in this area. WHO and UNAIDS have therefore recommended that all HIV testing must be voluntary, confidential, and should be undertaken with the patient's consent.

Patients should receive support to avoid potential negative consequences of knowing and disclosing their status, such as discrimination and violence, testing should be linked to appropriate HIV prevention, treatment, care and support. Provider-initiated HIV testing in health facilities should not be construed as an endorsement of coercive or mandatory HIV testing. 14 June 07