WHO releases new HIV testing guidelines

With the aim to reach an estimated 8.1 million people who are living with HIV, but remain unaware of their infection, the World Health Organization today released new and updated Consolidated Guidelines on HIV Testing Services For a Changing Epidemic. The guidelines recommended strategies to accelerate linkages to care, improve outreach to the most marginalized populations, and to extend dual HIV/Syphilis testing as the first test in all antenatal settings. Among the new recommendations are:

• Use of "social network" HIV testing of contacts among networks of diagnosed individuals to increase diagnoses among men who have sex with men, people who inject drugs, people who earn income through sex work, transgender women and incarcerated individuals;
• A move by all countries away from using Western blot testing to confirm HV diagnoses, which can take from four to six weeks to deliver results (he U.S. Centers for Disease Control and Prevention recommended discontinuing the tests in 2014, in favor of faster and more reliable tests);
• The use of HIV/Syphilis rapid tests as the first test in antenatal care settings, to accelerate elimination of mother to child transmission of both diseases;
• Consideration of building incentives into testing and linkage.
• Three consecutive  positive tests before HIV diagnosis (most high prevalence countries relied on two)

Updated guidelines, with strengthened recommendations, include HIV self testing as "a gateway to diagnosis"  and expanded community-based rapid testing offered by lay providers.