Many people still unaware of their HIV status – new UNAIDS report highlights

Nov 28, 2018 News

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Although there has been an increase in the number of people who know their HIV status, a recently released UNAIDS report suggest that 9.4 million people living with the disease do not know they are living with the virus.
They urgently need to be linked to HIV testing and treatment services.
The new report shows that intensified HIV testing and treatment efforts are reaching more people living with HIV. In 2017, for instance, three quarters of people living with HIV or 75 percent, knew their HIV status, compared to just two-thirds or 67 percent in 2015.
Some 21.7 million people living with HIV or 59 percent had access to antiretroviral therapy, up from 17.2 million in 2015.

The report, ‘Knowledge is power’, reveals that although the number of people living with HIV, who are virally suppressed, has risen by around 10 percentage points in the past three years, reaching 47 percent last year; 19.4 million people living with HIV still do not have a suppressed viral load.
To remain healthy and to prevent transmission, the virus needs to be suppressed to undetectable or very low levels through sustained antiretroviral therapy. And to effectively monitor viral load, people living with HIV need access to viral load testing every 12 months.
“Viral load testing is the gold standard in HIV treatment monitoring,” said Michel Sidibé, Executive Director of UNAIDS. “It shows that treatment is working, keeping people alive and well and keeping the virus firmly under control.”
The report outlines that access to viral load testing is mixed. In some parts of the world, getting a viral load test is easy and is fully integrated into a person’s HIV treatment regime, but in other places there may be only one viral load machine for the entire country.
“Viral load monitoring needs to be as available in Lilongwe as it is in London,” said Mr Sidibé. “HIV testing and viral load testing should be equal and accessible to all people living with HIV, without exception,” he added.
Viral load testing is particularly important for newborns, as HIV progresses much faster in children.
It has been found that mortality for children born with HIV could be within two or three months of life. Standard rapid diagnostic testing is ineffective up until 18 months of age, so the only viable test for HIV for very young children is a virological test, which they need to receive within the first four to six weeks of life.
However, in 2017, only half [52 percent] of children exposed to HIV in high-burden countries received a test within the first two months of life.
However, important advances are being made, the report highlights. This is in light of the fact that new point-of-care testing technologies—testing that takes place in an environment as close to the person as possible—have been shown to shorten the time it takes to return children’s test results from months to minutes, which is saving lives.
The report shows that one of the biggest barriers to HIV testing is stigma and discrimination. Studies among women, men, young people and key populations have revealed that fear of being seen accessing HIV services, and if the person is diagnosed; fear that this information will be shared with family, friends, sexual partners or the wider community, was preventing them from accessing HIV services, including HIV testing.
For key populations—gay men and other men who have sex with men, transgender people, sex workers, people who use drugs, people in prisons and other closed settings and migrants—these barriers can affect access to an even greater extent.
Stigma and discrimination, from society and health services, can deter members of key populations from accessing health care, while criminal laws can compound that discrimination, increase rates of violence and create additional barriers, including fear of arrest and harassment.
Other barriers include violence or the threat of violence, especially among young women and girls.
Also, parental consent laws and policies are also a barrier, since in some countries young people under the age of 18 years need parental consent to take an HIV test. In addition, services are often too far away and difficult to access or too expensive.
There can also be delays or failures in returning HIV test results and delays in treatment initiation.
In some countries, people do not seek HIV testing as they feel they are not at risk. The report, moreover, highlights how providing a variety of testing options and services, such as community-based testing and home-based testing, can help mitigate many of the logistical, structural and social barriers to HIV testing.
They offer testing options for people who live far away from health services, do not have the constraints of inconvenient opening hours, which is particularly important for men and people from key populations, and do not come with the stigma and discrimination often perceived in traditional health and HIV services, the report underscores.

 

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