UN health agency issues new guidelines on HIV self-testing

HIV testing in Haiti. Photo: UNDP

29 November 2016 – Ahead of World AIDS Day, marked annually on 1 December, the United Nations World Health Organization (WHO) has released new guidelines on HIV self-testing, which aim to help millions of people know their HIV status and get treatment.

“Millions of people with HIV are still missing out on life-saving treatment, which can also prevent HIV transmission to others,” said WHO Director-General Margaret Chan in a news release.

“HIV self-testing should open the door for many more people to know their HIV status and find out how to get treatment and access prevention services,” she added.

According to a WHO progress report, lack of an HIV diagnosis is a major obstacle to implementing the Organization’s recommendation that everyone with HIV should be offered antiretroviral therapy (ART).

The report says more than 18 million people with HIV are currently taking ART, but a similar number of people is still unable to access treatment, the majority of which are unaware of their HIV positive status. Today, 40 per cent of all people with HIV (over 14 million) remain unaware of their status.

The new guidelines aim to help countries scale up implementation of HIV self-testing and assisted HIV partner notification services.

HIV self-testing means people can use oral fluid or blood- finger-pricks to discover their status in a private and convenient setting. Results are ready within 20 minutes or less. Those with positive results are advised to seek confirmatory tests at health clinics. WHO recommends they receive information and links to counselling as well as rapid referral to prevention, treatment and care services.

Between 2005 and 2015, the proportion of people with HIV learning of their status increased from 12 per cent to 60 per cent globally. This increase in HIV testing uptake worldwide has led to more than 80 per cent of all people diagnosed with HIV receiving ART.

Men account for only 30 per cent of people who have tested for HIV. Testing also remains low among men who have sex with men, sex workers, transgender people, people who inject drugs, and people in prisons – who together comprise approximately 44 per cent of the 1.9 million new adult HIV infections that occur each year.

The new WHO guidelines recommend ways to help HIV positive people notify their partners about their status, and also encourage them to get tested.

Currently, 23 countries have national policies that support HIV self-testing. Many others are developing policies, but wide-scale implementation of HIV self-testing remains limited. WHO supports free distribution of HIV self-test kits and other approaches that allow self-test kits to be bought at affordable prices. WHO is also working to reduce costs further to increase access.

Another highlight of this year’s World AIDS Day is the launch of the hands up for #HIVprevention campaign that will explore different aspects of HIV prevention and how they relate to specific groups of people, such as adolescent girls and young women, key populations and people living with HIV.

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