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Monday 21st May 2018

Call for universal HIV testing

1st December 2008

A team of researchers from the World Health Organisation (WHO) has called for universal voluntary HIV testing.


If followed by immediate antiretroviral treatment (ART), such testing could drastically reduce the global occurrence of HIV by 95%, according to computer modelling.
The strategy aims to encourage safer sex practices in people who know themselves to be infected with HIV.

Treatment in infected persons would lower the levels of the HIV virus in the body, decreasing the likelihood of transmission.

By the end of 2007, around three million had received ART. A further 2.7 million became infected during the same year, and an estimated 6.7 million had not received treatment.

Scientists made mathematical models of data from South Africa, the country with the world's highest infection rate. The models demonstrated the long-term effect of the strategy proposed by the WHO.

In the data, those in the test community aged 15 or over were tested for HIV on a yearly basis. In the case of a positive diagnosis, ART would be immediately administered.

In building the model, it was assumed that all cases of HIV would be heterosexually transmitted.

The results of this research show that the transition into an elimination phase in which most infected adults are on ART could be achieved within five years.

Mortality could decrease rapidly, as healthcare services were relieved of the constant pressure of newly infected people.

The epidemic could begin to resemble a concentrated epidemic with particular populations remaining at risk.

The focus of control would switch from making ART available to people in most need to providing support and services for those who are receiving ART.

Transmission could be reduced to low levels and the epidemic could steadily decrease.

Human rights issues raised by the WHO proposal would include the toxicity and side-effects of the treatment.

Currently, HIV positive patients are not given ART until it becomes necessary for survival.

Professor Geoffrey Garnett of Imperial College London said that the suggested strategy would reflect public health at its best and at its worst.

While it would prevent morbidity and mortality for the population, it could also lead to over-testing, over-treatment, side-effects, resistance, and potentially reduced autonomy of the individual in their choices of care, he said.


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