Next time you visit your family doctor, don鈥檛 be surprised if you鈥檙e offered an HIV test. New guidelines issued by the World Health Organization on 30 May have recommended that doctors everywhere, including richer nations, consider routinely offering the test.
The aim is to identify carriers before they unwittingly spread the virus or get too ill to benefit from treatment. In some parts of sub-Saharan Africa where HIV is rife, only 12 per cent of men and 10 per cent of women know their HIV status, while research in the US has shown that unwitting carriers account for 50 to 70 per cent of new infections.
鈥淚 think this is extremely important,鈥� says Kevin De Cock, the WHO鈥檚 HIV/AIDS director. 鈥淭his is advice for countries and it must be country-led.鈥� The guidelines stress that no one should feel forced to take a test, and people can opt out. But by offering tests much more routinely, the hope is to de-stigmatise HIV infection. Only in 鈥渉igh-burden鈥� countries would all visitors to surgeries be offered the test. Elsewhere it would be confined to those at greatest risk, such as intravenous drug users.
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The WHO decided to act following encouraging results from countries that had already introduced routine testing, such as Kenya, where 85 to 95 per cent of people now agree to be tested. The US also introduced routine testing for all citizens aged 13 to 64 last September (快猫短视频, 24 July 2006, p 8).
However, there are concerns that testing may not be appropriate for those who can鈥檛 get access to antiretroviral drugs 鈥� a total of 72 per cent of people infected with HIV globally. Even so, De Cock says they can still benefit from interventions such as better nutrition.
