In a change of HIV antibody testing policy recommendations, the Joint United Nations Programme on HIV/AIDS and the World Health Organization announced Saturday that HIV testing should be routine in developing-world countries where the virus is widespread and treatment is accessible, while still allowing patients to opt out. Patients who visit clinics "for whatever reason" and are not offered HIV tests represent a missed chance to diagnose HIV infection or even discuss how to prevent the disease.
Under the new policy recommendation, routine testing would take place in tandem with safeguards against the discrimination that dissuades some from taking an HIV test. "The environment of AIDS is changing dramatically," said UNAIDS director Peter Piot. "Not only is there a globalization of the epidemic across Asia and Eastern Europe, but there is also a fundamental shift in the response, where treatment is becoming far more available."
WHO endorsed the idea of the new policy in response to doctors' reports that they were seeing patients they suspected of having HIV but were required by the old policy to wait for the patient to initiate discussion about testing. Access to lifesaving HIV therapy outweighs the need to avoid possible discrimination, said Jim Yong Kim, director of WHO's HIV department. Testing must always be consensual, confidential, and linked with counseling, he added.
In Botswana, which switched to routine testing in January, the proportion of patients taking HIV-antibody tests has jumped from 20% to 80%. "You realize very quickly that the whole paradigm of voluntary counseling and testing does not make sense at all in a country where you have a generalized epidemic," said Ernest Darkoh, head of Botswana's national AIDS program. (AP)