Can trained lay providers perform HIV testing services? A review of national HIV testing policies

Abstract

BackgroundOnly an estimated 54% of people living with HIV are aware of their status. Despite progress scaling up HIV testing services (HTS), a testing gap remains. Delivery of HTS by lay providers may help close this testing gap, while also increasing uptake and acceptability of HIV testing among key populations and other priority groups.Methods50 National HIV testing policies were collated from WHO country intelligence databases, contacts and testing program websites. Data regarding lay provider use for HTS was extracted and collated. Our search had no geographical or language restrictions. This data was then compared with reported data from the Global AIDS Response Progress Reporting (GARPR) from July 2015.ResultsForty-two percent of countries permit lay providers to perform HIV testing and 56% permit lay providers to administer pre-and post-test counseling. Comparative analysis with GARPR found that less than half (46%) of reported data from countries were consistent with their corresponding national HIV testing policy.ConclusionsGiven the low uptake of lay provider use globally and their proven use in increasing HIV testing, countries should consider revising policies to support lay provider testing using rapid diagnostic tests.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2339-1) contains supplementary material, which is available to authorized users.

To err is human, to correct is public health: a systematic review examining poor quality testing and misdiagnosis of HIV status

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“…As countries adopt these new guidelines, there is renewed scrutiny to ensure the validity of HIV testing programmes. Since 1997, WHO has been recommending retesting prior to ART initiation; however, a 2015 review of 48 national HIV testing policies found that only two programmes included testing before ART initiation in their national guidelines [13]. As of April 2017, Swaziland has not adopted retesting prior to ART initiation.…”

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