BANGKOK, Thailand – The current strategy of leaving it to patients to request an HIV test is not working in the developing world, where 90 percent of those infected with the AIDS virus have no idea they are carrying it, U.N. health experts said Saturday.
The U.N. AIDS agency and World Health Organization said countries where HIV is widespread and where treatment is available should test routinely – while allowing patients to opt out.
“The environment of AIDS is changing dramatically. Not only is there a globalization of the epidemic across Asia and Eastern Europe, but there is also a fundamental shift in the response, where treatment is becoming far more available,” said Dr. Peter Piot, chief of UNAIDS.
The change in recommended policy was announced ahead of today’s opening of the International AIDS Conference.
Patients who visit clinics “for whatever reason” and are not offered HIV tests represent missed opportunities for early diagnoses of AIDS – or even chances to discuss prevention, Piot said.
“At the moment there are millions of missed opportunities,” he said.
Routine testing would come in tandem with safeguards against discrimination. Many people have avoided HIV tests fearing stigma if people know they are infected.
“We are recommending a complete package in which testing and counseling, working on stigma, social mobilization and the offer of treatment happen simultaneously,” said Dr. Jim Yong Kim, director of the WHO’s HIV department.
WHO has mulled routine testing for years but has not announced it as U.N. policy until now. It got behind the idea after doctors reported seeing patients they strongly suspected were HIV positive but felt constrained by the old policy requiring patients to initiate discussion about a test.
“We thought that we had to take a much stronger stand,” Kim said, adding that the test must always be consensual.
Botswana, which has the highest HIV prevalence in the world, shifted to routine testing in January, with the proportion of patients tested for HIV jumping from 20 percent to 80 percent.
Almost everybody who comes into a health center is given a test – unless they object, said Dr. Ernest Darkoh, head of Botswana’s national AIDS program.
Talk to us
> Give us your news tips.
> Send us a letter to the editor.
> More Herald contact information.
