Improving access to HIV testing and counselling for key populations

WHO/C. Doan

On World AIDS Day 2013 (1 December), the World Health Organization (WHO) in the Western Pacific recognizes progress on HIV/AIDS across the Region and calls for community partnership approaches to improve access to appropriate HIV testing and counselling among key populations, such as men who have sex with men, transgender people, people who inject drugs and sex workers.

Advances in Asia and the Pacific

Important gains have been achieved in combating the HIV/AIDS epidemic in Asia and the Pacific. From 2003 to 2012, the rate of new HIV infections in the region decelerated and the HIV epidemic showed tentative signs of stabilizing. New HIV infections have steadily declined from 130 000 in 2003 to 110 000 in 2012.

Although countries in Asia and the Pacific have made significant strides to expand coverage of antiretroviral treatment in recent years, in 2012 only 51% of people eligible for antiretroviral treatment were receiving it. If access to antiretroviral treatment is to be increased (to levels committed to by nations through the 2011 United Nations General Assembly Political Declaration on HIV/AIDS: Intensifying Our Efforts to Eliminate HIV and AIDS), there is an urgent need to change current approaches to HIV testing and counselling in the region.

These advances reflect a coordinated effort to combat the HIV/AIDS epidemic. Moving forward, key priorities will be to build community partnerships to deliver appropriate services and to improve access to appropriate HIV testing.

Priority 1: Building community partnerships to deliver services

WHO strongly encourages voluntary community-based HIV testing on a confidential basis. HIV testing is indispensable to maximizing the effectiveness of antiretroviral therapy as it ensures that those in need receive treatment. A number of studies have shown that community-based testing and counselling programmes help reduce stigma and discrimination, while encouraging treatment and safeguarding human rights. WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) do not recommend coerced or mandatory testing of any individuals.

Dr Shin Young-soo, WHO Regional Director for the Western Pacific, explains: “Facility-based HIV testing services need to reach key populations who are currently under-served. To achieve this, health facilities are urged to partner with community organizations that are trusted by the key populations and understand how to deliver services that are ethical, convenient, acceptable and effective."

Priority 2: Improving access to appropriate testing

For key populations, access to testing is inhibited by fears of stigma, discrimination and disclosure of HIV-positive status. Across Asia and the Pacific, less than half of key populations know their HIV status, which leads to late diagnosis and late initiation of care and treatment services, resulting in unnecessarily high mortality for people living with HIV.

This also means the benefits of antiretroviral therapy are not fully maximized in the region. Taking action to improve access to services and reduce stigma and discrimination, WHO and the United Nations Development Programme recently launched The Time Has Come, an online training package for health workers to improve sexual health services for men who have sex with men and transgender people. Dr Shin further explains: "Suboptimal access to HIV testing and counselling, especially for key populations, remains a serious cause for concern in Asia and the Pacific.”

WHO continues to call for greater efforts to enhance access to prevention, treatment, care and support services for key populations, through strengthening partnership between ministries of health and communities, by promoting more proactive, simplified HIV testing and counselling strategies, and maximizing the treatment and prevention benefits of antiretroviral treatment.

For further information, please contact:

Dr Ying-Ru Jacqueline Lo
Team Leader, HIV/AIDS and Sexually Transmitted Infections
Telephone: +632 528 9714
E-mail: loy@wpro.who.int

Mr Ruel E. Serrano
Assistant, Public Information Office
Telephone: +632 528 9993
E-mail: serranor@wpro.who.int

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