Communities are a unique force behind the success of the HIV response

Of the 37.9 million people living with HIV at the end of 2018, 79% received testing, 62% received treatment, and 53% had achieved suppression of the HIV virus with reduced risk of infecting others.

Thousands of community health workers and members of the HIV and key population networks – many of whom are living with HIV or affected by the epidemic – contributed to this success.

On World AIDS Day 2019, WHO is highlighting the difference these communities are making to end the HIV epidemic while drawing global attention to the need for their broader engagement in strengthening primary health care.

WHO is releasing new recommendations on HIV testing services on 27 November ahead of World AIDS and the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA2019) taking place in Kigali, Rwanda on 2-7 December.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus will participate in events for World AIDS Day in Rwanda and deliver a keynote address at the opening of the ICASA2019.

5 Messages for Policy-makers!

1. Today 4 in 5 people with HIV get tested and 2 in 3 get treatment: communities played a major role in achieving this success. 

• Of the estimated 37.9 million people living with HIV at the end of 2018, 79% were diagnosed, 62% received treatment, and 53% had achieved suppression of the HIV virus with low risk of infecting others.
• One of the key contributors to this success in all countries has been the thousands of members of HIV and “key population” community networks and community health workers, many of whom are living with or affected by HIV.

• WHO recommends a strategic mix of approaches for testing, including community-based testing, self-testing, and provider-assisted referral to reach people at the highest risk of HIV.
• Countries like South Africa and Rwanda have shown how trained peers or community health workers have delivered rapid diagnostic tests with same-day results, enabling more people to know their HIV status.
• WHO recommends increased rapid testing in community settings for key populations in Europe, Asia, and the Americas to replace laborious approaches causing weeks of delays in test results and treatment initiation.
• WHO is also adding new recommendations to mobilize community-based social networks for increasing demand for HIV testing, including self-testing and to promote dual HIV/syphilis rapid tests and new digital tools.

• WHO recommends countries train and mobilize community health workers, including people living with HIV, to provide decentralized and differentiated HIV treatment and care.
• Evidence shows more people continue with HIV treatment when peer educators counsel and support each other.
• WHO also recommends that community health workers support monitoring and data collection.

• Health services are struggling to provide all people with HIV services they need.  Global fast-track targets for HIV for 2020 are unlikely to be met unless more support becomes available.
• The most glaring gap is seen in prevention. In 2018, 1.7 million people were newly infected with HIV – this number must reduce by three-fold to meet the 2020 target of 500 000.
• Testing and treatment coverage is off-track too – especially for key populations and children. For example, more than half of all new infections are among key populations and their partners; only half of the children in need are receiving ART, of which only half achieved viral suppression due to the use of suboptimal medicines.