Statement on HIV testing services
A variety of approaches to HIV testing services is recommended
The WHO consolidated guidelines on HIV testing services and the HIV self-testing and partner notification guidelines2, 3, recommend that HIV testing services be available through a wide range of service delivery models and approaches tailored to the epidemiological context in order to reach all populations, especially populations currently being underserved by existing services.
Facility-based testing approaches include provider-initiated testing and counselling (PITC), where providers routinely offer HIV testing to all people attending health services in high-prevalence settings (without the need to make an assessment of HIV risk), including sexual and reproductive health, tuberculosis (TB), harm reduction, antenatal, childbirth and postpartum services. PITC is also recommended in all epidemic settings for all people attending outreach and other services tailored to the needs of key populations. In countries with high HIV prevalence, WHO recommends the routine offering of HIV testing to all people attending health services. In countries with low HIV prevalence, WHO recommends that health-care providers in health-care settings assess the risk factors for HIV of each individual and routinely offer HIV testing to people who have had a high risk of HIV exposure or have an ongoing risk of contracting HIV, including people from key populations, the partners of people living with HIV or from key populations and people presenting with sexually transmitted infections and/or TB or HIV indicator conditions.
Community-based testing approaches include mobile outreach, door-to-door/home-based testing and workplace testing. HIV testing services can be delivered by community members with certified training in HIV testing (i.e. lay and peer providers); testing services do not need to be exclusively provided by health worker personnel such as nurses and doctors. Community providers of HIV testing should adhere to the national algorithms for testing and confirming results.