New Vision (Kampala)

Uganda Launches Mandatory HIV Testing

All people who seek treatment in public health centres across the country will undergo mandatory HIV testing under a new plan to increase access to HIV prevention and treatment, the health ministry has announced.

Under the multimillion dollar programme codenamed 'provider-initiated testing', HIV counseling and testing will be incorporated in the routine medical care, according to Dr. Alex Ario, acting manager of the AIDS Control Programme.

The UN World Health Organization issued guidelines for healthcare provider-initiated counseling and testing in 2007.

In Uganda, mandatory testing was first piloted on expectant mothers attending antenatal care and general patients at regional referral hospitals in 2009.

However, Ario explained that the system would be rolled out to cover Health Center IVs and IIIs across the country this year. Some private health facilities that receive supplies from the Government will also implement the programme at zero cost to patients.

"Mandatory HIV testing will now form the many tests conducted when a patient is admitted. It will be part and parcel of our routine medical care practice to let more people know their status to augment HIV prevention and treatment campaigns," said Ario.

Ario, however, explained that even when the tests are done, patients will not be compelled to know their results.

"Mandatory testing is advantageous to us health workers as well as the patients. It will promote better management of ailments. But this does not mean that patients will not be counseled," he said.

"If a patient is unwilling to know his HIV status on the first visit to the health center, we shall wait when he returns and is ready to receive the results."

Uganda employs a number of testing strategies, including: routine HIV testing for pregnant women; client-initiated counseling and testing; home-based HIV testing; couples HIV testing; mobile HIV testing; and moonlight (night-time) testing for high-risk groups such as sex workers.

According to government statistics, HIV testing is available in 80% of county-level health centres but only 22% of sub-county-level health centres. |

The number of people tested for HIV annually has gone up from 1.1 million in 2008 to 5.5 million in 2011.

The new strategy is part of efforts to lower Uganda's HIV prevalence, which climbed from 6.4 percent to 7.3 percent between 2006 and 2011.

Studies have shown that beyond the benefits of having HIV-positive people identified and referred for treatment, provider-initiated counseling and testing May also result in less risky sexual behaviour, reducing levels of HIV transmission.

"There are so many benefits of knowing their HIV status. Those who are HIV-negative will be careful and avoid engaging in risky behaviours. They will carry out preventive options such as partner notification, abstinence and safer sex," Ario told IRIN/PlusNews.

"Those who are HIV-positive will be enrolled in antiretroviral treatment and have increased opportunities for social support to live normally."

Anti-HIV activists welcomed the start of the new programme, but warned that the government must improve the health system in order to cope with the likely increase in treatment numbers.

"It's a good initiative. It will enable people to guard and take care of themselves. But our health system is struggling. It has not measured up. We have serious shortages of health workers in the health facilities," Florence Buluba, the executive director of the National Community of Women Living with AIDS (NACWOLA), told IRIN.

"The government first needs to address the challenges the health sector is facing before rolling out the programme."

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