Analysis: WHO Tells Docs to Test for HIV

May 30, 09:58 PM

Current Headlines: By OLGA PIERCE

New U.N. guidelines tell doctors to suggest HIV testing, instead of waiting for patients to request it.

Under the guidelines, unveiled Wednesday by the World Health Organization and UNAIDS, healthcare providers everywhere who treat patients at high risk of HIV are advised to suggest testing. But in countries facing a widespread epidemic, they advise doctors to recommend tests for all patients anywhere they seek healthcare.

Organizations fighting AIDS celebrated the guidelines as a step toward identifying the estimated 31 million out of the 39.5 million people living with the disease worldwide who are unaware they are infected. But human rights concerns clouded the announcement.

We think these new guidelines are extremely important, said Kevin De Cock, director of HIV and AIDS programs at the WHO.

As we struggle to move toward universal access to testing, treatment and support, HIV diagnosis is an important first step," he told reporters on a conference call.

People who do not know they have HIV do not receive life-prolonging treatment and counseling to prevent them from spreading the disease to others, De Cock said. When doctors recommend testing, patients are more likely to find out their status.

The catch is that in some countries there have been reports of mandatory testing, breaches of confidentiality and discrimination. If friends and neighbors are informed a patient has HIV, the person could be shunned. If an employer is given that information, the person could be fired.

In those countries, De Cock said, the guidelines call for strong monitoring and enforcement to make sure testing helps people instead of hurting them.

Some human rights organizations, however, are concerned that a wide-scale rollout of testing programs will not take discrimination into account.

The guidelines are helpful in the sense that countries around the world have been looking to the WHO for guidance, Joe Amon, director of the HIV/AIDS program at Human Rights Watch, told United Press International. But we already know in some countries HIV testing is done without good protections. Violations happening today are real concerns.

Human Rights Watch reports document human rights violations involving testing in countries in Asia, Europe and Africa.

Because of the definition of epidemic, the guidelines tell about 50 countries to recommend testing to all patients, Amon said. Those countries will need to be committed to protecting the rights of HIV patients.

Existing resources need to be mobilized to carefully watch testing, and major campaigns should be launched to persuade the public to help people with HIV, instead of hurting them with discrimination, he said.

More people have to know their status, but just knowing isn't enough.

But other advocates say the critical need for testing outweighs other concerns.

The worst discrimination people with HIV and AIDS face is premature death because of lack of treatment, said Michael Weinstein, president of the AIDS Healthcare Foundation, a U.S.-based group that provides treatment for the disease domestically and around the world.

One billion people per year need testing, and that will never be possible unless it is incorporated into the general healthcare system, he told UPI. The group practices routine testing at centers in the United States, Uganda and other countries, and that has dramatically increased the testing rate.

"If we knew every infected person today and counseled them not to infect their partners, we would achieve global AIDS control relatively quickly, Weinstein said.

A majority of people with HIV and AIDS in the world don't know. You cannot combat AIDS on a global basis without early detection.