WHO publishes new HIV testing recommendations

The World Health Organization (WHO) has published new consolidated guidelines on HIV testing services, which aims to help countries treat the 8.1 million people that have undiagnosed HIV.

HIV testing is important to ensure people are quickly diagnosed with HIV, thus ensuring they can receive appropriate treatment. Good testing services also ensure that people who test HIV negative are linked to appropriate prevention services. It is believed following these new guidelines will reduce the 1.7 million new HIV infections that occur every year around the world.

The WHO guidelines were released ahead of World AIDS Day on 1 December 2019, and the International Conference on AIDS and Sexually Transmitted Infections in Africa, which takes place in Kigali, Rwanda from 2-7 December 2019. Currently, two-thirds of all people with HIV in the world live in Africa.

The new guidelines recommend a range of new approaches.

• Encouraging all countries to adopt a standard HIV testing strategy which uses three consecutive reactive tests to provide an HIV positive diagnosis. 
• Recommending countries use HIV self-testing as a gateway to diagnosis based on new evidence that people who are at higher HIV risk and not testing in clinical settings are more likely to be tested if they can access HIV self-tests. 
• Recommending social network-based HIV testing to reach key high-risk populations who have less access to services. These include men who have sex with men, people who inject drugs, sex workers, transgender population and people in prisons. 
• Highlighting the use of peer-led, digital communications, such as short messages and videos, to build demand and increase uptake of HIV testing. 
• Recommending focused community efforts to deliver rapid testing, through lay providers, for relevant countries in the European, South-East Asian, Western Pacific and Eastern Mediterranean regions, where the longstanding laboratory-based method called ‘western blotting’ is still in use. 
• Promoting the use of HIV/syphilis dual rapid tests in antenatal care to help eliminate mother-to-child transmission of both infections. It is hoped this will help close the testing and treatment gap, and combat the second leading cause of stillbirths globally. 
• More integrated approaches for HIV, syphilis and hepatitis B testing is also encouraged.

Source: WHO, 27 November 2019