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Country adherence to WHO recommendations to improve the quality of HIV diagnosis: a global policy review
- Source :
- BMJ Global Health
- Publication Year :
- 2020
- Publisher :
- BMJ Publishing Group, 2020.
-
Abstract
- IntroductionEnsuring a correct and timely HIV diagnosis is critical. WHO publishes guidelines on HIV testing strategies that maximise the likelihood of correctly determining one’s HIV status. A review of national HIV testing policies in 2014 found low adherence to WHO guidelines. We updated this review to determine adherence to current recommendations.MethodsWe conducted a comprehensive policy review through April 2018. We extracted data on HIV testing strategies, recommendations on HIV retesting prior to antiretroviral therapy (ART) initiation and pre-exposure prophylaxis (PrEP)-related HIV testing information. Descriptive analyses disaggregated by region were conducted to ascertain adherence to recommendations and to describe testing strategy characteristics.ResultsOf 91 policies included, 26% (n=24/91) adhered to WHO recommendations. Having a two-assay testing strategy to rule-in HIV infection as opposed to the recommended three-assay testing strategy was a major reason for non-adherence. Of 72 country policies providing sufficient information, 31% (n=22) recommended retesting for HIV prior to initiating ART. Of 25 countries and two regions reporting PrEP-related HIV testing guidelines, almost all recommended testing prior to initiating PrEP and every 3 months during PrEP use.ConclusionsGlobal adherence to WHO recommendations for HIV testing strategies have improved since 2014 but remain low. We found adherence existed on a continuum. Such a system provides insights into how countries can move towards adherence by making relatively minor changes to testing strategies. Guidance from WHO on the role of new HIV testing technologies within testing algorithms and identifying ways to simplify testing guidance is warranted.
- Subjects :
- Test strategy
medicine.medical_specialty
media_common.quotation_subject
HIV diagnosis
Human immunodeficiency virus (HIV)
HIV Infections
diagnostics and tools
medicine.disease_cause
World Health Organization
03 medical and health sciences
0302 clinical medicine
Who recommendations
Global policy
medicine
Humans
Quality (business)
030212 general & internal medicine
Health policy
media_common
Original Research
0303 health sciences
030306 microbiology
business.industry
screening
Public Health, Environmental and Occupational Health
HIV
health policy
Policy
Family medicine
Who guidelines
Pre-Exposure Prophylaxis
business
Subjects
Details
- Language :
- English
- ISSN :
- 20597908
- Volume :
- 5
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- BMJ Global Health
- Accession number :
- edsair.doi.dedup.....c3f98f79b1aaff8fea39442a19e199a7