Need to normalise HIV testing and treatment

There was a time when HIV was untreatable, heavily stigmatised, and the benefits of testing weren’t as clear as they are now. But that was 25 years ago.

HIV testing remains the crucial entry point for all HIV services, including both prevention and treatment.

When someone tests and learns they are HIV positive, there is an opportunity to access life-saving treatment that will ensure their own wellbeing and that of their intimate partners. When someone learns they are HIV negative, there is an opportunity to evaluate their risk and assess which HIV prevention options are the best fit for them.

UNAIDS estimates 76% of people living with HIV in eastern and southern Africa know their status. While an HIV-positive diagnosis can still provoke fear among some, 85% of people with HIV in SA know their status.

The goal is that by 2020, 90% of people with HIV should know their status. Increasing the uptake of testing is an essential first step in this quest, which is part of a package of goals aimed at ending the epidemic.

Many people still struggle to overcome barriers to testing. These include access to testing and the stigma related to testing. However, many of the hurdles might not be as big as once thought.

HIV testing is free in SA in all public clinics and health facilities, but for many people just getting to the clinic can seem a barrier.

One solution lies in the increasing availability of HIV selftesting kits. Now getting a test can be as simple as going to the pharmacy and following the instructions.

A common concern is around confidentiality and being judged.

This is especially so among young people who are at risk of HIV infection, but may feel as if they would be judged for being sexually active. It’s estimated 2,000 adolescent girls and young women in SA are infected every week.

This problem needs to be tackled by helping young people access testing.

This can be done by providing youth-friendly services where healthcare professionals are friendly, non-judgemental and supportive. Testing must be normalised and seen as an appropriate, responsible and acceptable thing to do.

Aside from the stigma around HIV, many high-risk groups (such as sex workers, men who have sex with men and injecting drug users) still face enormous barriers to accessing traditional services due to stigmatisation, discrimination and even criminalisation.

The World Health Organisation and the South African government recommend testing every six to 12 months. But most people only test when they feel they have been at risk. In a South African context, where the prevalence of HIV is so high – 20.6% of adults aged 15 to 49 have HIV – everyone is at risk and should get tested every year.