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HIV self-testing in southern Africa


For the first time the World Health Organization (WHO) is recommending that individuals should be encouraged to test themselves for HIV infection with quality-assured simple-to-use rapid diagnostic tests.
WHO is also recommending so called assisted partner notification, which means that anyone whose test result is confirmed positive should contact their sexual partners to let them know with the help of a trained professional.
According to a new WHO guideline released on World AIDS Day on 1 December, HIV self-testing should be considered as an additional approach to conventional HIV testing services. Guidelines on HIV self-testing and partner notification are intended as a supplement to WHO’s consolidated guidelines on HIV testing services. 

“Programmes should evaluate their existing HIV testing approaches and determine where and how to implement HIV self-testing so that it is complementary and addresses gaps in current coverage,” a policy brief on the guidance says.
HIV self-testing is when an individual collects his or her own oral fluid or blood sample, performs an HIV test and interprets the result alone or with a trusted person. The diagnostic tests may be distributed by trained providers or peers or bought over the counter in pharmacies or through the Internet. For decades health workers and other people have informally tested themselves for HIV, but it is the first time that WHO has recommended self-testing.

As with all HIV testing, the result of a single rapid diagnostic test is not sufficient to diagnose HIV infection.
According to the new guidance, self-testers who produce a reactive test result (HIV positive) are advised to receive further testing from a trained tester using a validated national algorithm to confirm the result and provide a diagnosis. This should be linked to an assessment for HIV treatment. (December 2016, WHO Bulletin).

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Posted: 2 December 2016