WHO calls for routine HIV test

June 12, 2007 :: Tamar Kahn,Durban Business Day,South Africa

World Health Organisation (WHO) HIV/AIDS director Kevin de Cock yesterday urged SA to offer routine, confidential HIV testing to all patients at clinics and hospital, in the hope of radically increasing the proportion of people who know their status. The WHO recommended last week that countries hard hit by HIV stop relying on people to seek out HIV tests and move towards "provider-initiated" testing instead, while still allowing people to decline the offer of such tests. "I think the guidelines are one of the most important things we've done in a long time and they should be implemented in SA," he said on the sidelines of the third South African National AIDS conference. More HIV testing would help prevent new infections and improve the life expectancy of people who had the disease, De Cock said. "Most HIV-infected people go to great lengths to avoid transmission to other people and find abhorrent the idea they may infect someone else," he said in an interview. "Even in the industrialised world there are a huge number of people who only find out that they are HIV infected around the time they develop an opportunistic infection (associated with) advanced disease. "It's not cost effective to have people diagnosed late ... it's also dangerous because late initiation of therapy is associated with adverse outcomes." The WHO estimates about a fifth of the people infected with HIV in poor countries know they are carrying the virus. But in SA, only about 2% of the population has taken such tests, according to Southern African HIV Clinicians Society president Dr Francois Venter. HIV testing has been a hot topic at the conference, partly in response to a provocative Sunday Times article by Venter, advocating mandatory HIV testing. Delegates yesterday filled a hall for a debate on the issue, which is expected to be tackled in the conference declaration tomorrow. De Cock said he did not consider funding to be a limiting factor for provider-initiated HIV testing, as rapid tests were simple to administer and did not require expensive laboratory analysis. "Where we are lagging behind is the capacity to do molecular diagnosis for children," he said. Tests for children under 18 months require laboratory analysis. De Cock said he thought it unlikely that patients would be coerced into taking HIV tests.