Call for Rethinking of HIV Testing Policy

[Guest guest]

AIDS Experts Call for Rethinking of Testing Policy

LONDON (Reuters) - AIDS experts in the United States have called for

a rethinking of public HIV (news - web sites) testing policy, saying

new technology to diagnose the AIDS virus could streamline the

procedure and reduce the spread of the disease.

In a letter to The Lancet medical journal on Friday, Jane

Rotheram-Borus of the UCLA AIDS Institute and Mark Etzel of the UCLA

Center for Community Health in California said a flexible approach to

counseling is needed because a new, rapid HIV test can produce a

result within an hour.

Instead of counseling people before and after testing, counseling

should only be given if the test is positive or if the person reports

high-risk behavior, they said.

" Local clinics are forced to spend their money on counseling staff

instead of needed drugs and treatment. Freeing these resources will

open up new services for HIV-infected persons, " said Rotheram-Borus.

Under the current US system, people are counseled, tested and told to

come back in a week for their results. But some 700,000 tests are

wasted because people do not return, according to the researchers.

" People seek treatment and change their behavior when they learn they

are HIV-positive, " Rotheram-Borus said.

" If people don't return for their test results, they will maintain

their behavior, increasing the risk of infecting others through

perinatal transmission, sex or needle sharing, " she added.

The researchers said the new model could also free up resources in

developing countries hit hard by AIDS. Nearly 30 million people in

sub-Saharan Africa are living with HIV/AIDS. Approximately 3.5

million people were infected in 2002.

[Guest guest]

Dear Forum,

I think it is important to counsel both; those who are testing positive as

well as those who test negative. Those testing negative should be informed

about how to stay negative. A small proportion of those testing negative may

be in the window period. If we fail to counsel those testing negative, we

are missing important opportunities for prevention.

This is especially relevant in the context of countries where the epidemic is

rapidly becoming more and more generalised.

Dr. Reynold Washington

India-Canada Collaborative HIV/AIDS Project

Associate Professor: Community Health, St. 's Medical College,Bangalore

E-mail: reynold@...

[Guest guest]

Dear Forum,

To add to Dr. Washington's comment: those who test negative need counselling as:

They may have come for the test too early following risk behaviour - in the

'window period' - therefore testing negative does not necessarily translate into

them being negative. To utilise the opportunity to do some behaviour change

communication.

However, all that may change soon: We already have HIV testing kits that can

give a result within one hour and when these testing kits/methods hit the market

soon, the question will be between whether pre- post-test counselling will have

any value at all or not, or whether funds earmarked for counselling services

will be better utilised for treatment, care and support. Studies are already

underway that raise this question.

Thanks,

Dr. Amitrajit Saha MD

Advisor,

DURBAR

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