Report on the Global HIV/AIDS epidemic

Report on the global HIV/AIDS epidemic - June 2000

Opening new doors with counselling and testing
Most of the 34.3 million people worldwide now living with HIV do not know they are
carrying the virus. The proportion is highest in the countries worst affected by the
HIV epidemic.
There are many reasons for this state of affairs, including ignorance about HIV, lack
of suitable counselling and testing services, and the still widespread stigma attached
to AIDS which can result in rejection and even violence against people known to be
HIV-positive. People also fear that a positive result means an immediate death sentence, although this is not true. In a developing country someone who has just been
infected with HIV can expect to live nine years on average before falling seriously ill
and to survive up to a year beyond that, even in the absence of antiretroviral therapy.
As daunting as the barriers to HIV testing are, it is important to tackle them. When
people learn their infection status early on, there can be important benefits for both
prevention and care. People who discover they are HIV-negative can take more
energetic measures to remain uninfected, including negotiating with their partner to
go for testing or use condoms. People in a stable relationship who test positive for
HIV can take steps to protect their partner from becoming infected through sexual
transmission and avoid mother-to-child transmission of the virus. Access to lifeprolonging treatment is an incentive for testing: new research shows that, even in
developing countries, inexpensive medication can improve survival and help an HIVpositive person to stay healthy and productive longer (see pages 105-106). The family also stands to benefit when an infection is discovered early enough to permit
advance planning for the financial security of the survivors. Finally, important benefits to the community flow from HIV counselling and testing, especially when people
with HIV feel safe enough to be open about their infection and become involved in
the fight against the epidemic - the GIPA principle (see page 87). People living with
HIV can bring first-hand experience to AIDS action and help neighbours, institutions
and policy-makers face up to the reality of the epidemic.
When properly carried out, voluntary HIV testing and counselling can help break the
vicious circle of fear, stigma and denial. The benefits are both individual and collective and extend beyond the immediate value of knowing one's own infection status.
An interesting example comes from Uganda's AIDS Information Centre, an organization that has provided confidential counselling and HIV testing to 350 000 clients

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