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WHO, UNAIDS Issue New Guidance on HIV Testing and Counseling

The WHO and UNAIDS today issued new guidance on informed, voluntary 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 as recommended by health care providers in health facilities.

Today, approximately 80 percent of people living with HIV in low- and middle-income countries do not know that they are HIV-positive. Recent surveys in sub-Saharan Africa showed on average just 12 percent of men and 10 percent of women have been tested for HIV and received their test results.

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.

"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," he added.

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.

Current evidence also suggests many opportunities to diagnose HIV in clinical settings are being missed, even in places with serious HIV epidemics. While, therefore, 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.

"If we are going to get ahead of this epidemic, rapidly scaled up HIV treatment and prevention efforts are critical - and increased uptake of HIV testing will be fundamental to making this a reality," said Dr Paul De Lay, Director of Monitoring and Evaluation, UNAIDS.

"At the same time, and in all cases of HIV testing and counseling, the 3 Cs - that is consent, confidentiality and counseling - must be respected," he added.


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