Contraceptive Dynamics Following HIV Testing
Barriers to HIV Services and Treatment for Persons with Disabilities in Zambia
The 80-page report documents the obstacles faced by people with disabilities in both the community and healthcare settings. These include pervasive stigma and discrimina
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tion, lack of access to inclusive HIV prevention education, obstacles to accessing voluntary testing and HIV treatment, and lack of appropriate support for adherence to antiretroviral treatment. The report also describes the sexual and intimate partner violence women and girls with disabilities face, and the need for the government and international donors to do more to ensure inclusive and accessible HIV services.
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Social network-based HIV testing is an approach for engaging sexual and drug injecting partners and social contacts of key population members with HIV and of those who are HIV-negative and at ongoing risk in voluntary HTS.
By addressing people’
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s confidentiality concerns and broadening the reach to social contacts, social network-based HIV testing approaches can improve the acceptability of partner services among key populations and so reach more people who may not otherwise test for HIV. WHO now recommends that social network-based HIV testing approaches can be offered for key populations
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Case Study on Improving HIV Testing and Services for Children Orphaned or made Vulnerable by HIV (OVC)
Policy brief.
Globally, one in five people with HIV are unaware of their status, despite considerable scale up of HIV testing, treatment and prevention services. Many of those unreached by HIV
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testing services (HTS) are from key populations, partners of people with HIV and, in Eastern and southern Africa, men and young people. Improving the availability, accessibility, friendliness and quality of services is important to address these testing gaps.
At the same time, tools and interventions that increase the demand for HTS are needed to reach people who are uninformed about HTS options and advances in treatment and prevention, people who are not motivated to seek HTS and those who are hesitant to test because of fear of an HIV diagnosis or other reasons.
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Hepatitis B (HBV) infection is a major public health problem and cause of chronic liver disease.
The 2024 HBV guidelines provide updated evidence-informed recommendations on key priority topics. These include expanded and simplified treatment criteria for adults but now also for adolescents; expa
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nded eligibility for antiviral prophylaxis for pregnant women to prevent mother-to-child transmission of HBV; improving HBV diagnostics through use of point-of-care HBV DNA viral load and reflex approaches to HBV DNA testing; who to test and how to test for HDV infection; and approaches to promote delivery of high-quality HBV services, including strategies to promote adherence to long-term antiviral therapy and retention in care.
The 2024 guidelines include 11 updated chapters with new recommendations and also update existing chapters without new recommendations, such as those on treatment monitoring and surveillance for liver cancer.
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Countries are making progress toward the global goal of 95% of people living with HIV knowing their status by 2025. However, considerable gaps remain in achieving these goals globally. Men in high HIV burden settings and men from key populations in all settings are consistently less likely to know t
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heir HIV status than women. Globally, 78% of men ages 15 years and older who are living with HIV are aware of their HIV status, compared with 86% of women with HIV of these ages.
Offering HIV testing services, including HIV self-testing, at formal and informal workplaces has emerged as an effective, acceptable and feasible approach for reaching men. A 2018 World Health Organization (WHO) and International Labour Organization (ILO) policy brief provides key guiding principles for HIVST implementation at workplaces. Building on the 2018 policy brief, this brief captures early experience with HIVST implementation at workplaces and discusses emerging approaches of sustainable financing that can be adapted for HIV self-testing at workplaces.
The primary audiences for this policy brief are ministries of health and labour, national HIV programmes, employers’ organizations, workers’ organizations (labour unions), enterprises, implementing partners, including civil society organizations, and health insurance agencies.
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The coronavirus outbreak that began in 2019 (COVID-19) threatens to reverse years of hard-won gains in preventing and treating HIV. Fragile health systems are further stressed as health workers navigate an increased client load and demands at work while also being concerned for their own health and
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that of their families. Health facilities have been redesigned to care for patients with COVID-19, posing challenges to other services. Governments and civil society organizations have redirected scarce resources and shifted programming priorities to respond to the pandemic. Several countries have reported intermittent declines in HIV testing and diagnosis, antenatal care visits, collection of antiretroviral medicines (ARVs) by people living with HIV, and attendance at clinic appointments. Community-based education and support programmes have had to rapidly adapt to restrictions on movement and public gatherings. Children, adolescents, and women have experienced multiple deprivations due to the adverse impact of the pandemic.
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Policy Brief, Updated in March 2017
Key messages
• The criminalisation of male-to-male sex heightens HIV and other sexually transmissible infection (STI) risks and vulnerabilities, and hinders access to HIV and STI services including HCT
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• Men who have sex with men (MSM) and transgender persons (TG) are not a homogeneous group. As such, a variety of HCT service models are needed to reach the various segments of these populations.
• Stigma and discrimination remain ongoing issues at a number of service points. Targeted training of service providers is therefore needed so that MSM and TG are not discouraged from seeking HCT and high-quality prevention, treatment and care services.
• Specific guidelines on HIV prevention, treatment and care services for MSM or TG help improve the delivery of services.
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Information note.
This information note provides a strategic overview of key implementation considerations for diagnostic integration using these devices, and is primarily intended for use by national laboratory services and TB, HIV, and hepati
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tis programme managers.
It may also be of interest to managers of maternal, newborn and child health programmes and sexual and reproductive health programmes, international and bilateral agencies, and organizations that provide financial and technical support to the relevant national health programmes.
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WHO recommends replacing western blotting and line immunoassays with simpler tests in HIV testing services. These simpler tests include rapid diagnostic tests (RDTs) that can be used at the point-of
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-care, and enzyme immunoassays (EIAs).
These tests get results to the client faster, produce accurate results more often, cost less, can be performed by various cadres of health providers, and can thus facilitate greater access and uptake of HIV testing services among those who need it most.
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These guidelines provide new and updated recommendations on the use of point-of-care testing in children under 18 months of age and point-of-care tests to monitor treatment in people living with HIV; the treatment monitoring algorithm; and timing of
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antiretroviral therapy (ART) among people living with HIV who are being treated for tuberculosis.
New recommendations launched today outline key new actions that countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for differentiated approaches such as, supporting HIV treatment start in the community, ensuring that children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and triggers clinical action
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External quality assessment (EQA) is an important component of quality systems for blood transfusion services. Establishing external quality assessment programmes for screening of donated blood for transfusion-transmissible infections (TTI): impleme
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ntation guide aims to support WHO member States in establishing and operating EQA programmes for screening donated blood for TTI. The guides has been designed for use by national health authorities and EQA organizing institutions in the development of EQA programme. It will also give participating laboratories an insight into the organization of EQA programmes for TTI screening and an understanding of the benefits of participation.
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Policy brief. HIV testing services (HTS) and anti-retroviral therapy (ART) have been scaled up substantially. It is estimated that, globally, nearly 80% of people with HIV now know their status. Wit
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h the offer of immediate ART initiation and improved treatment options, access to and uptake of treatment have increased, too. Now, most people with HIV who know their status are obtaining treatment and care.
In response to these changes in the global HIV epidemic, WHO is encouraging countries to use three consecutive reactive tests for an HIV-positive diagnosis as their treatment-adjusted prevalence and national HTS positivity fall below 5% .
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Policy Brief
HIV testing services
December 2016
WHO/HIV/2016.21