World AIDS Day: Over 14 million HIV positive people unaware of infection; WHO recommends self-testing

Kolkata: More than 18 million people with HIV are currently taking antiretroviral therapy (ART) with a similar number still unable to access the life-saving treatment, the WHO has said, as it issued new guidelines on self-testing to improve access to HIV diagnosis. The World Health Organisation (WHO) report issued on the eve of World AIDS Day on Thursday said lack of HIV diagnosis is a major obstacle in implementing the WHO’s recommendation that everyone with HIV should be offered ART. Today 40 percent of all people with HIV, numbering over 14 million remain unaware of their status. Many of these are people at higher risk of HIV infection who often find it difficult to access existing testing services, it said. “Millions of people with HIV are still missing out on life-saving treatment, which can also prevent HIV transmission to others,” WHO Director-General Margaret Chan said. [caption id=“attachment_2743984” align=“alignleft” width=“380”]  Representational image. Reuters[/caption] “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,” she said. WHO has released new guidelines stressing on HIV self-testing to improve access to and uptake of HIV diagnosis. HIV self-testing means people can use oral fluid or blood-finger-pricks to discover their status in a private and convenient setting, the WHO release said. Results are ready within 20 minutes or less. Those with positive results are advised to seek confirmatory tests at health clinics. WHO recommended that they receive information and links to counselling as well as rapid referral to prevention, treatment and care services. HIV self-testing is a way to reach more people with undiagnosed HIV and 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. This is particularly important for those facing barriers to accessing existing services, the report said. Between 2005 and 2015 the proportion of people with HIV learning of their status increased from 12 per cent to 60 per cent globally, the release added. This increase in HIV testing uptake worldwide has led to more than 80 percent of all people diagnosed with HIV receiving the ART, the WHO release said. HIV testing coverage remains low among various population groups. For example, global coverage rates for all HIV testing, prevention and treatment are lower among men than women. Men account for only 30 per cent of people who have tested for HIV. As a result men with HIV are less likely to be diagnosed and put on ART 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 south Africa experience infection rates up to eight times higher than among their male peers. Fewer than one in every five girls between 15 years and 19 years of age are aware of their HIV status, the report said. Testing also remains low among ‘key populations’ and their partners - particularly among sex workers, transgenders, people injecting drugs, and prisoners - who comprise approximately 44 per cent of the 1.9 million new adult HIV infections that occur each year, it said. 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. Twenty three countries currently have national policies supporting HIV self-testing. Many other countries are developing policies, but wide- scale implementation of HIV self-testing remains limited, the release said. WHO supports free distribution of HIV self-test kits and other approaches that allow self-test kits to be bought at affordable prices. It is also working to reduce costs further to increase access, the release said adding the new guidance aims to help countries scale up implementation.