AEGiS-Glasgow [PL4.2] Virtues of "opt-out" testing as the point of entry to expanded access to ART in developing countries

Seventh International Congress on Drug Therapy in HIV Infection

Glasgow, UK - 14-17 November 2004

[PL4.2] Virtues of "opt-out" testing as the point of entry to expanded access to ART in developing countries

Int Cong Drug Therapy HIV 2004 Nov 14-18;7:Abstract No. PL4.2

Ferdinand M. Mugusi
Muhimbili University College of Health Sciences, Dar Es Salaam, Tanzania

The use of effective antiviral agents has significantly improved the prognostic possibilities for many people with AIDS in the developed world. There are initiatives by WHO and other international organizations to expand access to Antiretroviral therapy (ART) to as many people as possible, especially in high prevalent areas of sub Saharan Africa. The provision of ART needs to address a number of challenges, including the identification of individuals who are HIV positive among large populations. The HIV testing strategy that requires pre test counseling followed by a post test counseling is long, cumbersome and sometime viewed by patients with suspicion as the test is offered differently from other tests. A properly done pre and post test counseling requires a good environment for confidentiality, enough time and adequate number of well trained personnel, all these cannot be provided by most health care settings in developing countries. In Tanzania alone it is estimated that about 500,000 of the 2.2 million people living with HIV/AIDS who need to be tested require ART. If these initiatives are to be effective in providing treatment to as many patients as possible in Tanzania like in many other developing countries, a quick and more efficient HIV testing strategy needs to be employed. A strategy that can offer the patient HIV testing as a routine test, at the same time allowing her/him to "opt out" if she/he does not like the test. This strategy that also uses rapid tests to provide same day results, aims at dropping the long pre-test counseling sessions while allowing more physicians with little experience in counseling to contribute to more widespread HIV-testing. It is this kind of strategy that will probably help the health care systems in sub Saharan Africa cope with the large numbers of patients that require ART.

SESSION 4: RESOURCE-POOR SETTINGS [IAS SESSION]

2004-11-14
PL4.2

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