4 in 10 people with HIV don’t know status

The World Health Organisation has issued new guidelines to broaden self-testing for HIV amidst concern that up to 18 million people living with the virus, majority of them unaware of their HIV-positive status, are unable to access treatment.

The guidelines allow for rapid testing lasting up to 20 minutes, using oral fluid, blood, or finger prick “in a private and convenient setting”, before a confirmatory test at a clinic.
“Millions of people with HIV are still missing out on life-saving treatment, which can also prevent HIV transmission to others,” said Dr Margaret Chan, WHO Director-General.

“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.”

Ahead of World AIDS Day, a WHO progress report said lack of an HIV diagnosis was a major obstacle impeding WHO recommendation that every with HIV be offered antiretroviral therapy.

“By offering HIV self-testing, we can empower people to find out their own HIV status and also to notify their partners and encourage them to get tested as well,” said Dr Gottfried Hirnschall, director of WHO’s Department of HIV.

“This should lead to more people knowing their status and being able to act upon it. Self-testing will be particularly relevant for those people who may find it difficult to access testing in clinical settings and might prefer self-testing as their method of choice.”

The organisation said testing would help reach more people with undiagnosed HIV and was a “step forward to empower individuals, diagnose people earlier before they become sick, bring services closer to where people live, and create demand for HIV testing.”

“This is particularly important for those people facing barriers to accessing existing services.

Around the world coverage rates for all HIV testing, prevention, and treatment are lower among men than women, the report notes.

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

But some women miss out too. Adolescent girls and young women in East and Southern Africa experience infection rates up to eight times higher than among their male peers.

Fewer than one in every five girls (15–19 years of age) are aware of their HIV status.

Testing also remains low among “key populations” and their partners – particularly men who have sex with men, sex workers, transgender people, people who inject drugs, and people in prisons – who comprise approximately 44% of the 1.9 million new adult HIV infections that occur each year.

Up to 70 % of partners of people with HIV are also HIV positive. Many of those partners are not currently getting tested.
The new WHO guidelines recommend ways to help HIV positive people notify their partners about their status, and also encourage them to get tested.