WHO recommends: check yourself for HIV infection

On the eve of World AIDS Day, WHO is releasing a new guide to HIV self-testing

November 29, 2016, Geneva. On the eve of World AIDS Day, the World Health Organization (WHO) has released a new guide on HIV self-testing to improve access to HIV diagnosis services and increase their use (WHO recommends HIV self-testing).

According to a new WHO progress report, gaps in HIV diagnosis are one of the main obstacles to implementing the Organization's recommendation that everyone with HIV receive antiretroviral therapy (ART).

The report shows that more than 18 million people with HIV are currently receiving ART, and the same number of people still do not have access to treatment, and most of them do not know about their HIV-positive status. Today, 40% of all people with HIV (more than 14 million) do not know about their status. Many of them are among the people at increased risk of HIV infection, who often find it difficult to contact existing services for testing.

"Millions of people with HIV are still not receiving life–saving treatment that can also prevent HIV transmission to others," said Dr Margaret Chan, WHO Director-General. "Self–testing for HIV will allow many more people to know their HIV status and figure out how to get treatment and access to prevention services."

Self-testing for HIV means that people can find out their status at home using their saliva or blood taken from a finger. The result will be ready in about 20 minutes. People who have received a positive result are advised to contact a medical institution for a confirmatory test. According to WHO recommendations, they need to be provided with information and counseling, as well as immediately referred to prevention, treatment and care services.

HIV self-testing opens up opportunities to reach more people with undiagnosed HIV and is a step forward towards empowering individuals, providing diagnosis at an early stage, that is, before the disease develops, bringing services closer to people's place of residence and creating demand for HIV testing. This is especially important for people facing obstacles in accessing existing services.

Between 2005 and 2015, the proportion of people with HIV who are aware of their status has increased from 12% to 60% globally. Such an increase in the use of testing services in the world has led to the fact that more than 80% of all people with HIV are receiving ART.

Who remains not covered by HIV testing?

HIV testing coverage remains low among different population groups. For example, global coverage of all HIV testing, prevention and treatment services among men is lower than among women.

Men account for only 30% of people tested for HIV. As a result, men with HIV are less likely to be diagnosed with HIV and are less likely to receive antiretroviral therapy and are more likely to die from HIV-related causes than women.

But some women also remain uncovered. Infection rates among adolescent girls and young women in Eastern and Southern Africa are up to eight times higher than those among their male peers. Less than one out of every five girls (15-19 years old) they know about their HIV status.

Testing levels also remain low among "key populations" and their partners – especially men who have sex with men, sex workers, transgender people, people who inject drugs, and people in prison - they account for approximately 44% of the 1.9 million annual new infections among adults.

Up to 70% of the partners of people with HIV are also HIV-positive. Currently, many of these partners are not being tested. The new WHO guidelines contain recommendations on how to help HIV-positive people tell their partners about their status and encourage them to get tested.

"By offering self-testing, we give people the opportunity to find out their HIV status, as well as notify their partners and recommend them to get tested," said Dr. Gottfried Hirnschal, Director of the WHO HIV Department. – This should lead to an increase in the number of people who will know about their status and will be able to take measures in this regard. Self-testing will be especially important for people who may find it difficult to apply to medical institutions for testing and give preference to self-testing."

Self-testing has led to the fact that HIV testing rates among men who have sex with men have almost doubled, and recent studies in Kenya have shown that the levels of use of HIV testing among male partners of pregnant women with self-testing are twice as high as the levels of testing using standard methods.

Currently, 23 countries have national policies supporting HIV self-testing. Many other countries are developing policies, but the use of HIV self-testing remains limited. WHO supports the free distribution of HIV self-testing kits and other approaches that allow the purchase of self-testing kits at an affordable price. WHO is also working to further reduce costs in order to expand access. The new guidance aims to help countries scale up their use.

UNITAID STAR Project Zimbabwe. © UNITAID/Eric Gauss

WHO is supporting three countries in South Africa that have embarked on the large-scale use of self-testing as part of the UNITAID-funded STAR project, and many other countries are considering using this innovative approach to reach those people who are not covered by services.

Portal "Eternal youth" http://vechnayamolodost.ru  01.12.2016