WHO and UNAIDS issue new guidance on HIV testing and counseling in health facilities

New recommendations aim for wider knowledge of HIV status and greatly increased access to HIV treatment and prevention

30 MAY 2007 | LONDON -- WHO and UNAIDS today issued new guidance on informed HIV testing and counseling in the world's health facilities, with a view to significantly increasing access to needed HIV treatment, care, support and prevention services. The new guidance focuses on provider-initiated HIV testing and counseling (recommended by health care providers in health facilities). Increased access to HIV testing and counseling is essential to promoting earlier diagnosis of HIV infection, which in turn can maximize the potential benefits of life-extending treatment and care, and allow people with HIV to receive information and tools to prevent HIV transmission to others.

Until recently, the primary model for providing HIV testing and counseling has been client-initiated HIV testing and counseling - also known as voluntary counseling and testing (VCT) - in which individuals must actively seek an HIV test at a health or community-based facility. But uptake of client-initiated HIV testing and counseling has been limited by low coverage of services, fear of stigma and discrimination, and the perception by many people - even in high prevalence areas - that they are not at risk.

"Scaling up access to HIV testing and counseling is both a public health and a human rights imperative," said WHO HIV/AIDS Director Dr Kevin De Cock. "We hope that the new guidance will provide an impetus to countries to greatly increase availability of HIV testing services in health care settings, through realistic approaches that both improve access to services and, at the same time, protect the rights of individuals. Without a major increase in HIV testing and counseling in health facilities, universal access to HIV prevention, treatment and care will remain just a noble goal."

Current evidence suggests that many opportunities to diagnose HIV in clinical settings are being missed, even in places with serious HIV epidemics. While expanded access to client-initiated HIV testing and counseling is still necessary, other approaches are also required if coverage of HIV testing and counseling is to increase and, ultimately, universal access to HIV prevention, treatment, care and support is to be achieved.

The new WHO/UNAIDS guidance was prepared in light of increasing evidence that provider-initiated testing and counseling can increase uptake of HIV testing, improve access to health services for people living with HIV, and may create new opportunities for HIV prevention. Provider-initiated HIV testing and counseling involves the health care provider specifically recommending an HIV test to patients attending health facilities. In these circumstances, once specific pre-test information has been provided, the HIV test would be performed, unless the patient declines. The new WHO/UNAIDS guidance is strongly recommended for countries with generalized HIV epidemic, and the option should be presented to all patients attending all health facilities, whether or not the patient has symptoms of HIV infection and regardless of the patient's reason for attending the health facility.

As countries work towards universal access to HIV prevention, treatment, care, and support, the new guidance on provider-initiated HIV testing and counseling offers an important opportunity to introduce new approaches and improve the standards of HIV testing and counseling in both public and private health facilities. Together with their partners, PAHO/WHO and UNAIDS will continue to help countries expand access to the full range of HIV testing and counseling services, as well as to other needed health sector interventions against HIV/AIDS. The PAHO/WHO Country Office in Belize will work closely with the Ministry of Health for the implementation of the new testing and counseling guidelines.

The Pan American Health Organization, which is the Regional Office of the World Health Organization, was founded in 1902, and works with all the countries of the Americas to improve the health and quality of life of their peoples. The PAHO/WHO Country Office in Belize was established in the 1950s .

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For further information, please contact:

Ms. Sandra Jones
PAHO/WHO Belize
P.O. Box 1834
Belize City

Tel: 224-4885, 224-5536
Fax: 223-0917
e-mail: admin@blz.paho.org
web: www.blz.paho.org