WHO issues new guidelines on HIV self-testing

MANILA, Philippines – Ahead of today’s commemoration of World AIDS Day, the World Health Organization (WHO) has come up with new guidelines on human immunodeficiency virus self-testing to improve access to HIV diagnosis.

In a report, the WHO said lack of diagnosis was a major obstacle in implementing the agency’s recommendation that everyone with HIV should be offered antiretroviral therapy (ART). 

Over 18 million HIV-infected people are currently on ART but a similar number are unable to access treatment, the majority of whom remain unaware of their HIV positive status, WHO said.

Some 40 percent or more than 14 million people with HIV are not aware of their status, it noted.

According to WHO director-general Margaret Chan, life-saving treatment for those infected can also prevent HIV transmission to others.

In January of this year, the WHO announced it was developing the new guidance on HIV self-testing, a process in which people could use oral fluid or finger-prick blood 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.

HIV self-testing is a way to reach more people with undiagnosed HIV and it also represents 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, the WHO said.

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

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

WHO added HIV testing coverage remained low among various population groups. For instance, the global coverage rates for all HIV testing, prevention and treatment are lower among men than women.

“Men account for only 30 percent 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,” it said.

But WHO maintained that some women were missing out too. Adolescent girls and young women in East and Southern Africa, for instance, experience infection rates up to eight times higher than their male peers.

Fewer than one in every five girls (15 to 19 years of age) is aware of her HIV status.

WHO added that “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 percent of the 1.9 million new adult HIV infections that occur each year. 

Up to 70 percent 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.

Self-testing has been shown to nearly double the frequency of HIV testing among men who have sex with men, and recent studies in Kenya found that male partners of pregnant women had twice the uptake of HIV testing when offered self-testing compared with standard testing, the WHO said.