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Intensified HIV testing and treatment efforts are reaching more people than ever but persistent barriers remain

29/11/2018

 
PictureCopyright: UNAIDS
75%  of all people living with HIV know their HIV status, but increased efforts are needed to reach the 9.4 million people living with HIV who are not aware that they are living with the virus, UNAIDS 2018 reports shows.

In 2017, three quarters of people living with HIV (75%) knew their HIV status, compared to just two thirds (67%) in 2015, and 21.7 million people living with HIV (59%) had access to antiretroviral therapy, up from 17.2 million in 2015. The report shows, however, that 9.4 million people living with HIV do not know they are living with the virus and urgently need to be linked to HIV testing and treatment services.

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% in 2017, 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.

The persistent barriers to knowing one’s status
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.

Next generation of testing options
The report 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.

Another important step to take is to integrate HIV testing services within other health services, including maternal and child health services, services for tuberculosis and services for sexually transmitted infections and viral hepatitis.

The report demonstrates that implementing these measures will hugely advance progress towards ensuring that all people living with and affected by HIV have access to the life-saving services they need.

In 2017 an estimated:
  • 36.9 million people globally were living with HIV
  • 21.7 million people were accessing treatment
  • 1.8 million people became newly infected with HIV
  • 940 000 people died from AIDS-related illnesses
​
Read more :
Knowledge is power - Report
Knowledge is power - Executive summary
Fact Sheet - World AIDS Day 2018

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