Abuja — The Minister of Health, Prof. Isaac Adewole, has said that more than 14 million people living with HIV globally which is about 40 per cent of all people with HIV do not know their status.
He said that it is in view of this that the WHO launched new guidelines on HIV self-testing during the World AIDS Day in 2016 in order to increase HIV Testing among those at high risk of HIV and support earlier diagnosis and access to treatment and prevention.
Adewole stated this yesterday in Abuja at the dissemination meeting of the evaluation reports of Amethyst HIV 1 & 2 Self-Test Kit Saliva Cassettes for HIV self-testing and ten antibody-based HIV Rapid Test Kits
He said that the key recommendation of the guidelines was that HIV self-testing (HIVST) should be offered as an additional approach to HIV testing services.
According to him, HIV testing is the gateway to HIV treatment and care services.
The Minister noted that in Nigeria, like other countries in the world, detection of specific antibodies in the blood or other body fluids is the main, easily affordable method and standard procedure for the diagnosis of HIV infection.
Speaking on the importance of self-testing to the possible eradication of HIV prevalence, Adewole said: "HIV self-testing is a new strategy intended to address challenges of increasing access to preliminary knowledge of sero-status. It provides the possibility for testing more people than ever before. HIVST gives benefits of access to treatment, self- checking of HIV status which is convenient and confidential.
"HIV self-testing (HIVST) is an empowering and innovative way to help achieve the first of the United Nations 90-90-90 treatment targets - which provides that 90% of all people with HIV should know their status by 2020. HIVST will contribute to the attainment of this global target by reaching first-time testers, as well as creating demand for and enabling more people to receive HIV testing, particularly the high-risk population," he explained.
He said in a country with a gradually improving economy like ours, HIVST increases the efficiency and effectiveness of the health system by focusing health services and resources on those with reactive self-test results who are in need of further testing, support and referral, thereby directing services more appropriately.
"Individuals with reactive self-test results who disclose their result to a provider should be advised and referred for clinical services for additional HIV testing, and where the HIV positive diagnosis is confirmed, the individual should be referred for treatment and care. Individuals with a nonreactive self-test result who disclose their result to a provider will usually not require further testing, but need to be tested within 6 to 12 weeks if they are at high risk of HIV infection", he advised.
In recognizing the importance of self-testing, Adewole said the Federal Ministry of Health is giving it a priority in order to accelerate the achievements of UNAIDS 90-90-90 targets in Nigeria, adding that the HIV programme has keyed into WHO recommendations for HIVST and has also included HIV self-testing into the reviewed National HIV Testing Services guidelines.
He said: "in 2016 I approved the conduct of the Evaluation of Amethyst HIV 1 & 2 Self-Test Kit Saliva Cassette because of the importance of self-testing and the contribution it will make in improving access to HIV Testing Services. This kit has the benefit of the non-invasive method of collection of specimen for HIV self-testing.
"The results of the evaluation which was conducted in 2016 at the National External Quality Assessment Laboratory, Zaria showed that Amethyst HIV 1 & 2 Self-Test Kit Saliva Cassette's sensitivity was 93.9% and its specificity was 93.2%. The Positive and Negative Predictive values of the kit to the Gold Standard were 86.8% and 96.8% respectively. These results met the requirements for the kit to be used for self-testing of HIV 1 & 2 in Nigeria".
In addition to this, he said the Ministry conducted three rounds of evaluation of HIV RTKs using the World Health Organization (WHO)-Afro guidelines for appropriate evaluation of HIV Testing Technologies in Africa where 3 phases of evaluation were recommended. The three phases are as follows; Phase I (laboratory based), Phase II (Field based) and Phase III (continuous monitoring of the performance of the algorithm).
He disclosed that Phase I (laboratory based) and phase II (Field based) have been completed for test kits evaluated under Round 1 (one) while test kits evaluated under Round 2 (two) are still awaiting phase II (Field based).
The Minister recommends that these algorithms be used with the other algorithms that are already in use in the country while he endorsed the report of Round 3-Phase 1 (Laboratory based) evaluation and direct the immediate implementation of the algorithm with quality management systems that will ensure a sustained quality and accessible HIV testing services in Nigeria.