WHO launched updated Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach. This publication brings together important clinical and programmatic updates produced by WHO since 2016 and provides comprehensive, evidence-informed recommendations and good practice statements within a public health, rights-based and person-centred approach.
These guidelines bring in the most recent guidance on HIV testing strategies – the entry point for HIV prevention and treatment – and include comprehensive guidance on infant diagnosis. Key recommendations are presented on rapid antiretroviral therapy (ART) initiation and the use of dolutegravir. Updated recommendations are included on the timing of ART for people with TB, and the use of point-of-care technologies for treatment monitoring.
Differentiated approaches to HIV service delivery are emphasized, with several recommendations made to allow treatment to be started outside of the health facility and to reduce the frequency of contact with health services for people who are doing well on treatment. These recommendations help to ensure that people with HIV can start and continue treatment during times of service disruption as a consequence of the COVID-19 pandemic.
Advanced HIV disease continues to be a global challenge. These guidelines bring a new chapter fully dedicated to this topic, summarizing the currently recommended WHO package of advanced HIV care and include the most recent WHO guidance for TB preventive therapy. The guidelines also summarize current WHO guidance on the management of common coinfections and comorbidities associated with HIV, including a new section on cervical cancer and new recommendations on HIV and Buruli ulcer coinfection and HIV and visceral leishmaniasis coinfection. Operational and service delivery guidance is included on optimising access to HIV services and to provide programmatic guidance for decision-makers and implementers.
The 2021 consolidated guidelines on HIV are an important step in supporting the goals of universal access to ARV drugs for preventing and treating HIV and ending the HIV/AIDS epidemic as a major public health threat by 2030.