To reach out to the People living with HIV (PLHIV) who are yet to be diagnosed and get treatment, the World Health Organisation (WHO) has issued new recommendations including a standard HIV testing strategy using three consecutive reactive tests to provide an HIV positive diagnosis and HIV self-testing to bring them under lifesaving care. The are atleast 8.1 million PLHIV who remain undiagnosed.
The new recommendations also include a range of innovative approaches to respond to contemporary needs. Previously, most high burden countries were using two consecutive tests. The new approach of using three tests can help countries achieve maximum accuracy in HIV testing.
"The face of the HIV epidemic has changed dramatically over the past decade," said WHO Director-General Dr Tedros Adhanom Ghebreyesus in a statement here recently. "More people are receiving treatment than ever before, but too many are still not getting the help they need because they have not been diagnosed."
Echoing similar concerns, Dr. Harsh Vardhan, Union Minister of Health at an event celebrating the World AIDS Day on Sunday said, "while we have travelled a long distance in our fight against AIDS and HIV, there are still some significant milestones that need to be achieved for making the country free of HIV AIDS by 2030, such as the lingering pockets of stigma and discrimination against those who have or have had AIDS."
The WHO has also recommended social network-based HIV testing to reach key populations, who are at high risk but have less access to services. These include men who have sex with men, people who inject drugs, sex workers, transgender population and people in prisons.
These "key populations" and their partners account for over 50 per cent of new HIV infections.
The use of peer-led, innovative digital communications such as short messages and videos can build demand- and increase uptake of HIV testing, said the WHO.
Using HIV/syphilis dual rapid tests in antenatal care as the first HIV test can help countries eliminate mother-to-child transmission of both infections. The move can help close the testing and treatment gap and combat the second leading cause of stillbirths globally. More integrated approaches for HIV, syphilis and hepatitis B testing is also encouraged, said the WHO.
"Saving lives from HIV starts with testing," says Dr Rachel Baggaley, WHO's Team lead for HIV Testing, Prevention and Populations. "These new recommendations can help countries to accelerate their progress and respond more effectively to the changing nature of their HIV epidemics."
At the end of 2018, there were 37.9 million people with HIV worldwide. Of these, 79 per cent had been diagnosed, 62 per cent were on treatment, and 53 per cent had reduced their HIV levels through sustained treatment, to the point at which they have substantially reduced risk of transmitting HIV.
In India, during 2018-19, around 79 per cent of PLHIV knew their HIV status, 82 per cent diagnosed with HIV infection are receiving free antiretroviral therapy and 79 per cent are virally suppressed.