Overview

These guidelines outline a public health approach to strengthening and expanding HIV testing services (HTS). They present and discuss key updates to WHO guidelines on HTS, with a focus on new evidence, new recommendations, good practices and operational considerations that respond to the changing needs of national programmes.

New recommendations in this guidance highlight the expanding role of self-testing and network-based testing services, as well as integration with sexually transmitted infections (STIs), including the use of syphilis self-test, dual HIV/syphilis self-tests and STI partner services.

This guideline seeks to provide support to Member States, programme managers, health workers and other stakeholders seeking to achieve national and international goals to end the HIV epidemic as a public health threat by 2030 and advance the importance of integrated services delivery.

Contents

• Acknowledgements
• Abbreviations
• Executive summary
• Chapter 1. Introduction
  • 1.1. Progress and challenges
  • 1.2. Rationale
  • 1.3. Goal and objectives
  • 1.4. Scope of the guidelines
  • 1.5. Intended audience
  • 1.6. Guiding principles
  • References
• Chapter 2. Methodology
  • 2.1. Overview
  • 2.2. Establishing the groups to develop the guidelines
  • 2.3. Defining the scope of the guidelines
  • 2.4. Review of the evidence
  • 2.5. Development of recommendations
  • 2.6. Evidence assessment
  • 2.7. Developing the recommendations
  • 2.8. Producing the guidelines
  • 2.9. Plans for dissemination
  • 2.10. Updating
  • References
• Chapter 3. Mobilizing demand for HIV testing services and pre-test information
  • 3.1. Introduction
  • 3.2. Creating an enabling environment
  • 3.3. Demand creation strategies and approaches
  • 3.4. Implementation considerations for demand creation interventions
  • 3.5. Concise pre-test Information and messaging
  • References
• Chapter 4. Essential post-test service package: counselling messages and linkage to prevention, treatment and other services
  • 4.1. Introduction
  • 4.2. Key post-test messages and information
  • 4.3. Linkage to HIV treatment, prevention, care, support and other relevant services
  • References
• Chapter 5. Service delivery approaches for HIV testing
  • 5.1. Introduction
  • 5.2. Health systems considerations for HTS delivery
  • 5.3. HTS delivery approaches
  • 5.4. Implementation considerations for successful delivery of testing services
  • References
• Chapter 6. Guidance for HIV testing services among priority populations
  • 6.1. Delivering HTS for priority populations
  • 6.2. Key populations
  • 6.3. Men
  • 6.4. Adolescents and young people
  • 6.5. Pregnant and postpartum women
  • 6.6. Infants and children
  • 6.7. Couples and partners
  • 6.8. Other vulnerable groups
  • References
• Chapter 7. Strategic planning for effective and efficient HIV testing services
  • 7.1. Introduction
  • 7.2. Core principles for implementing effective and efficient HIV testing services
  • 7.3. Knowing your context and epidemic
  • References
• Chapter 8. Selecting diagnostics for HIV diagnosis
  • 8.1. Introduction
  • 8.2. Where to conduct HIV testing
  • 8.3. Testing strategies for HIV-1 diagnosis
  • 8.4. Retesting for individuals over 18 months of age
  • 8.5. Testing for other conditions
  • 8.6. Recency testing in routinely offered HTS programmes
  • 8.7. Choosing HIV assays
  • 8.8. Verification of HIV testing algorithms
  • 8.9. Post-market surveillance
  • References
• Chapter 9. Quality assurance for HIV testing services
  • 9.1. Considerations for assuring the quality of HIV testing
  • 9.2. Assuring quality – what must be done at the national level
  • 9.3. Assuring quality – what must be done at the testing site level
  • 9.4. Quality improvement for HIV testing
  • References
• List of web annexes
  • Web Annex A. GRADE table and systematic review: should social network testing approaches be offered as an additional HIV testing approach?
    Annabelle Choong, Yi Ming Lyu, Eric P.F. Chow, Magdalena Barr-DiChiara, Muhammad S. Jamil, Nandi Siegfried, Rachel Baggaley, Cheryl C. Johnson, and Jason J. Ong.
  • Web Annex B. GRADE table and systematic review: should HIV self-testing be offered as an additional testing option in health facilities?
    Kathleen McGee, Muhammad S. Jamil, Nandi Siegfried, Busisiwe Msimanga Radebe, Magdalena Barr-DiChiara, Rachel Baggaley, and Cheryl Johnson.
  • Web Annex C. GRADE table and systematic review: should HIV self-testing be used to support PrEP delivery?
    Katrina F. Ortblad*, Adriana M. Reedy, Alexandra P. Kuo, Catherine Kiptinness, Nandi Siegfried, Magdalena Barr-DiChiara, Muhammad S. Jamil, Rachel Baggaley, Cheryl C. Johnson, and Anjuli D. Wagner.
  • Web Annex D. Modelling HIV self-testing for oral PrEP scale-up in Kenya: impact on HIV drug resistance and HIV outcomes
    Sarah N. Cox, Linxuan Wu, Rachel Wittenauer, Samantha Clark, D. Allen Roberts, Ifechukwu Benedict Nwogu, Olga Vitruk, Alexandra P. Kuo, Cheryl Johnson, Muhammad S. Jamil, Anita Sands, Robin Schaefer, Rachel Baggaley, Joanne D. Stekler, Adam Akullian, and Monisha Sharma.
  • Web Annex E. GRADE table and systematic review: should caregiver-assisted testing with HIV self-test kits be offered as an additional HIV testing approach for children 18 months and older?
    Kathleen McGee, Muhammad S. Jamil, Nandi Siegfried, Busisiwe Msimanga Radebe, Magdalena Barr-DiChiara, Rachel Baggaley, and Cheryl Johnson.
  • Web Annex F. GRADE table and systematic review: should HIV recency testing be used in routine programmatic HIV testing services?
    Eric Remera, Leon Mutesa, Nandi Siegfried, Muhammad Shahid Jamil, Celine Lastrucci, Magdalena Barr-DiChiara, Cheryl Johnson, and Rachel Baggaley.
  • Web Annex G. Values and preferences of key population communities in the Asia-Pacific region regarding HIV recency testing
    Asia-Pacific Coalition on Male Sexual Health (APCOM) Foundation - Bangkok.
  • Web Annex H. Case examples
  • Web Annex I. Declarations of interest – summary tables

Suggested citation:

Consolidated guidelines on differentiated HIV testing services. Geneva: World Health Organization; 2024. Licence: CC BY-NC-SA 3.0 IGO.

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