New guidelines released for couples HIV testing and counselling and for treatment and prevention in serodiscordant couples
GENEVA, 19 April 2012—New guidelines have been issued encouraging couples to go together for HIV testing in order to know their HIV status. The guidelines, released by the World Health Organization (WHO), also recommend that in couples who are serodiscordant—where one partner is living with HIV and the other not—antiretroviral therapy is offered to the person living with HIV to prevent his or her partner from becoming infected with the virus.
The Joint United Nations Programme on HIV/AIDS (UNAIDS) strongly welcomes the new guidelines and calls on all countries to implement them to reach the targets set in the United Nations 2011 Political Declaration on AIDS.
“Couples can now reap the benefits of antiretroviral therapy, to improve their own health, and to protect their loved ones,” said UNAIDS Executive Director Michel Sidibé. “By encouraging couples to test together, we can provide comprehensive options for HIV prevention and treatment—that they can discuss and manage jointly.”
New evidence now shows that antiretroviral therapy reduces the risk of HIV transmission from a person living with HIV to their sexual partners. WHO recommends that antiretroviral therapy be offered to HIV-positive individuals in discordant relationships even when they do not require it for their own health. The guidance also states that it is possible for couples to stay HIV serodiscordant indefinitely if they consistently practice safer sex using condoms.
“I am excited that with the roll out of these new guidelines, millions of men and women have one additional option to stop new HIV infections,” said Mr Sidibé. “This development begins a new era of HIV prevention dialogue and hope among couples.”
According the new guidelines, “couples who test together and mutually disclose their HIV status are more likely than those testing alone to adopt behaviour to protect their partner. Another potential benefit of couples testing together and sharing their results is that they can support each other, if one or both partners are HIV-positive, to access and adhere to treatment and prevent transmission of HIV to children”.
UNAIDS recommends that HIV testing and counselling should always be confidential and initiation of treatment must always be voluntary and never mandatory or coercive. Couples should have access to the full range of HIV prevention options available including the use of male and female condoms and medical male circumcision. They should also be provided with access to health services such as tuberculosis screening and reproductive health services including family planning with access to effective contraceptives and conception counselling for sero-discordant couples.
According to UNAIDS estimates, around 14 million people are eligible for antiretroviral treatment. At the end of 2011, only 6.6 million people were receiving the life-saving medicines. The guidelines recommend that in situations of limited or inadequate resources, people who require antiretroviral therapy for their own health should always be given priority.
