Guidelines for using HIV testing technologies in surveillance : selection, evaluation and implementation

ii Global surveillance of HIV/AIDS and sexually transmitted infections (STIs) is a joint effort of the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). The UNAIDS/WHO Working Group on Global HIV/AIDS and STI Surveillance , initiated in November 1996, is the main coordination and implementation mechanism for UNAIDS and WHO to compile the best information available and to improve the quality of data needed for informed decision-making and planning at national, regional and global levels. WHO and UNAIDS express their gratitude to those who have contributed their time and experience and provided precious inputs and suggestions for the development of these Guidelines. for providing scientific and technical expertise as well as for undertaking critical reviews of the draft manuscript. This document is not a formal publication of the World Health Organization (WHO) or the Joint United Nations Programme on HIV/AIDS (UNAIDS), and all rights are reserved. The document may, however, be freely reviewed, abstracted, reproduced or translated, in part or in whole, but not for sale or use in conjunction with commercial purposes. The views expressed in documents by named authors are solely the responsibility of those authors. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by WHO or UNAIDS in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. Box 1 Three different epidemic states _________________________________________2 Box 2 Linked and unlinked HIV testing _________________________________________5 Box 3 General outline for a country evaluation of HIV testing technologies ______________29 As the HIV/AIDS epidemic imposes an ever-larger burden globally, surveillance for HIV becomes more critical in order to understand the trends of the epidemic and to make sound decisions on how best to respond to it. This is especially true in developing countries, which account for a disproportionate share of new and long-standing infections. To help countries focus their surveillance activities in the context of their epidemic state (low-level, concentrated, or generalized), the World Health Organization (WHO) and the Joint United Nations Programme on HIV/ AIDS (UNAIDS) have developed a conceptual framework to improve HIV surveillance—second generation HIV surveillance. Guidelines for second generation HIV surveillance suggest approaches to make better use of data to increase and improve the response to the HIV epidemic. As biological surveillance (serosurveillance) is an …