WHO issues new guidelines on HIV/AIDS

By Joyce Nyakato

The World Health Organisation (WHO) has issued new guidelines encouraging couples to go together for HIV testing in order to know their HIV status.

The guidelines, also recommend that in couples who are sero- discordant, antiretroviral therapy (ART) is offered to the person living with HIV to prevent his or her partner from becoming infected with the virus.

Sero-discordant couples are where one partner is living with HIV and the other is not.

If couples go to test, they receive their results and mutually disclose their status in an environment where support is provided by a counsellor or health worker.

“A range of prevention, treatment and support options can then be discussed and decided upon together, depending on the status of each partner,” spells the WHO recommendation.

For couples where only one partner is HIV positive, the guidelines recommend offering antiretroviral therapy to the HIV positive partner, regardless of his or her own immune status (CD4 count). This is to reduce the likelihood of HIV transmission to the HIV negative partner.

Previous studies have shown that such treatment can prevent the transmission of HIV to their uninfected partners.

According to Dr. Noeline Kaleeba, the founder of TASO Uganda and HIV/AIDS activist, WHO feeds guidelines to a global audience but every country has the responsibility to domesticate them.

“All of the guidelines have to be weighed according to a country's context,” she says.

Stats

Today, only 40% of people with HIV globally know their HIV status. In Uganda, statitstics reveal that about to 50% of HIV-positive people in on-going relationships have HIV-negative partners.

Of those HIV-positive individuals who know their status, many have not disclosed their HIV status to their partners, nor do they know their partners' HIV status.

Consequently, a significant number of new infections occur within the discordant couples.

Sub-Saharan Africa is home to most of the people living with HIV/AIDS and it's where most of the HIV/AIDS deaths have occurred.

 In Uganda, a UNAIDS report reveals that  upto 50% of HIV-positive people in on-going relationships have HIV-negative partners.

Of those HIV-positive individuals who know their status, many have not disclosed their HIV status to their partners, nor do they know their partners' HIV status. Consequently, a significant number of new infections occur within discordant couples.

Recent evidence confirms the benefit of early ART for people with a CD4 count above 350 cells/µL in preventing transmission to HIV-negative partners.

“Treating people before their immune system collapses will prevent many opportunistic infections and save money in the long run,” HIV/AIDS experts agree.

However, the call for a for more widespread treatment comes during a time of budgetary constraints.

Kaleeba said before a guideline is adopted by a country, cost implications are going to be put into context.