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Abstract：
OBJECTIVE: In 2015 and 2016, WHO issued guidelines on HIV testing services (HTS) highlighting recommendations for a strategic mix of differentiated HTS approaches. The policy review examines the uptake of differentiated HTS approaches recommendations in national policies.
METHODS: Data were extracted from national policies published between January 2015 and June 2019. The WHO-recommended HTS approaches included facility-based testing, community-based testing, HIV self-testing and provider-assisted referral (or assisted partner notification). Other supportive recommendations include pre-test information, post-test counselling, lay provider testing and rapid testing. Descriptive analyses were conducted to examine inclusion of recommendations in national policies.
RESULTS: Of 194 countries worldwide, 65 published policies were identified; 24 WHO Africa region (AFR) countries (51%, 24/47), 21 WHO European region (EUR) (40%, 21/53), 6 WHO Eastern Mediterranean region (EMR) (29%, 6/21), 5 Pan-American region (AMR) (14%, 5/35), 5 Western Pacific Region (WPR) (19%, 5/27) and 4 WHO South East Asia Region (SEAR) (36%, 4/11). Only five countries included all recommendations. 63 included a minimum of one. 85% (n=55) included facility-based testing for pregnant women, 75% (n=49) facility-based testing for key populations, 74% (n=48) community-based testing for key populations, 69% (n=45) rapid testing, 57% (n=37) post-test counselling, 45% (n=29) lay provider testing, 38% (n=25) HIV self-testing, 29% (n=19) pre-test information and 25% (n=16) provider-assisted referral. The proportion in each region that included at least one recommendation were: 100% AFR (24/47), 100% EMR (6/6), 100% AMR (5/5), 100% WPR (5/5), 100% SEAR (4/4) and 95% EUR (20/21). AFR followed by EMR included the highest number of reccomendations.
CONCLUSIONS: There was substantial variability in the uptake of the WHO-differentiated HTS recommendations. Those in EMR included the most WHO-differentiated HTS recommendation followed by AFR. Countries within AMR included the least number of recommendations. Ongoing advocacy and efforts are needed to support the uptake of the WHO-differentiated HTS recommendations in country policies as well as their implementation.
METHODS: Data were extracted from national policies published between January 2015 and June 2019. The WHO-recommended HTS approaches included facility-based testing, community-based testing, HIV self-testing and provider-assisted referral (or assisted partner notification). Other supportive recommendations include pre-test information, post-test counselling, lay provider testing and rapid testing. Descriptive analyses were conducted to examine inclusion of recommendations in national policies.
RESULTS: Of 194 countries worldwide, 65 published policies were identified; 24 WHO Africa region (AFR) countries (51%, 24/47), 21 WHO European region (EUR) (40%, 21/53), 6 WHO Eastern Mediterranean region (EMR) (29%, 6/21), 5 Pan-American region (AMR) (14%, 5/35), 5 Western Pacific Region (WPR) (19%, 5/27) and 4 WHO South East Asia Region (SEAR) (36%, 4/11). Only five countries included all recommendations. 63 included a minimum of one. 85% (n=55) included facility-based testing for pregnant women, 75% (n=49) facility-based testing for key populations, 74% (n=48) community-based testing for key populations, 69% (n=45) rapid testing, 57% (n=37) post-test counselling, 45% (n=29) lay provider testing, 38% (n=25) HIV self-testing, 29% (n=19) pre-test information and 25% (n=16) provider-assisted referral. The proportion in each region that included at least one recommendation were: 100% AFR (24/47), 100% EMR (6/6), 100% AMR (5/5), 100% WPR (5/5), 100% SEAR (4/4) and 95% EUR (20/21). AFR followed by EMR included the highest number of reccomendations.
CONCLUSIONS: There was substantial variability in the uptake of the WHO-differentiated HTS recommendations. Those in EMR included the most WHO-differentiated HTS recommendation followed by AFR. Countries within AMR included the least number of recommendations. Ongoing advocacy and efforts are needed to support the uptake of the WHO-differentiated HTS recommendations in country policies as well as their implementation.
摘要：
目标：2015年和2016年，世卫组织发布了艾滋病毒检测服务（HTS）指南，强调了差异化HTS方法战略组合的建议。政策审查审查了在国家政策中采用差异化HTS方法建议的情况。
方法：数据来自2015年1月至2019年6月发布的国家政策。世卫组织推荐的HTS方法包括基于设施的测试，基于社区的测试，艾滋病毒自我检测和提供者协助转诊（或协助伴侣通知）。其他支持性建议包括预测试信息,测试后咨询，提供程序测试和快速测试。进行了描述性分析，以检查将建议纳入国家政策。
结果：在全球194个国家/地区中，确定了65项已发布的政策；24个世卫组织非洲区域(AFR)国家(51%，24/47),21世卫组织欧洲地区（欧元）（40%，21/53),6世卫组织东地中海区域(EMR)(29%，6/21),5泛美地区（AMR）（14%，5/35),5西太平洋地区（WPR）（19%，5/27）和4世卫组织东南亚区域（SEAR）（36%，4/11).只有五个国家纳入了所有建议。63个包含至少一个。85%(n=55)包括基于设施的孕妇检测，75%(n=49)对关键人群进行基于设施的测试，74%(n=48)基于社区的关键人群测试，69%(n=45)快速检测，57％（n=37）的测试后咨询，45%(n=29)外行提供商测试，38%（n=25）艾滋病毒自我检测，29%(n=19)的测试前信息和25%(n=16)的提供者辅助转诊。每个地区至少包含一项建议的比例为：100%AFR(24/47)，100%EMR(6/6),100%AMR(5/5),100%WPR(5/5),100%SEAR（4/4）和95%EUR（20/21）。AFR其次是EMR，其中包含最多的评论。
结论：对WHO区分的HTS建议的摄取有很大的差异。EMR中的那些包括WHO差异最大的HTS建议，其次是AFR。AMR中的国家纳入的建议数量最少。需要不断进行宣传和努力，以支持在国家政策中采用世卫组织区分的HTS建议及其实施。
方法：数据来自2015年1月至2019年6月发布的国家政策。世卫组织推荐的HTS方法包括基于设施的测试，基于社区的测试，艾滋病毒自我检测和提供者协助转诊（或协助伴侣通知）。其他支持性建议包括预测试信息,测试后咨询，提供程序测试和快速测试。进行了描述性分析，以检查将建议纳入国家政策。
结果：在全球194个国家/地区中，确定了65项已发布的政策；24个世卫组织非洲区域(AFR)国家(51%，24/47),21世卫组织欧洲地区（欧元）（40%，21/53),6世卫组织东地中海区域(EMR)(29%，6/21),5泛美地区（AMR）（14%，5/35),5西太平洋地区（WPR）（19%，5/27）和4世卫组织东南亚区域（SEAR）（36%，4/11).只有五个国家纳入了所有建议。63个包含至少一个。85%(n=55)包括基于设施的孕妇检测，75%(n=49)对关键人群进行基于设施的测试，74%(n=48)基于社区的关键人群测试，69%(n=45)快速检测，57％（n=37）的测试后咨询，45%(n=29)外行提供商测试，38%（n=25）艾滋病毒自我检测，29%(n=19)的测试前信息和25%(n=16)的提供者辅助转诊。每个地区至少包含一项建议的比例为：100%AFR(24/47)，100%EMR(6/6),100%AMR(5/5),100%WPR(5/5),100%SEAR（4/4）和95%EUR（20/21）。AFR其次是EMR，其中包含最多的评论。
结论：对WHO区分的HTS建议的摄取有很大的差异。EMR中的那些包括WHO差异最大的HTS建议，其次是AFR。AMR中的国家纳入的建议数量最少。需要不断进行宣传和努力，以支持在国家政策中采用世卫组织区分的HTS建议及其实施。
