{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:30:03Z","timestamp":1792290603583,"version":"4.4.0"},"reference-count":28,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"unspecified","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,3,3]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-058098","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T02:30:26Z","timestamp":1710383426000},"page":"e058098","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Country uptake of WHO recommendations on differentiated HIV testing services approaches: a global policy review"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8506-3216","authenticated-orcid":false,"given":"Tafadzwa","family":"Kadye","sequence":"first","affiliation":[{"name":"Global Health, UCL, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad S","family":"Jamil","sequence":"additional","affiliation":[{"name":"World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of HIV\/AIDS, World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Baggaley","sequence":"additional","affiliation":[{"name":"World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Barr-DiChiara","sequence":"additional","affiliation":[{"name":"Department of Global Programmes of HIV, Hepatitis and HIV, World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Cambiano","sequence":"additional","affiliation":[{"name":"UCL, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"2025101811110563000_14.3.e058098.1","unstructured":"UNAIDS . Fact sheet 2022. UNAIDS, 2022."},{"key":"2025101811110563000_14.3.e058098.2","unstructured":"UNAIDS . 2021 global AIDS update: confronting inequalities. 2021. Available: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2021-global-aids-update_en.pdf"},{"key":"2025101811110563000_14.3.e058098.3","unstructured":"UNAIDS . Aids targets: putting people living with HIV and communities at risk at the centre 2021. 2025. Available: https:\/\/aidstargets2025.unaids.org\/ [Accessed 23 Feb 2022]."},{"key":"2025101811110563000_14.3.e058098.4","unstructured":"UNAIDS . Fast-track strategy to end the AIDS epidemic by 2030. UNAIDS, 2014."},{"key":"2025101811110563000_14.3.e058098.5","unstructured":"WHO . Progress report on HIV, viral hepatitis and sexually transmitted infections, 2019 accountability for the global health sector strategies, 2016\u20132021. Geneva, Switzerland: WHO, 2019."},{"key":"2025101811110563000_14.3.e058098.6","unstructured":"WHO . Consolidated guidelines on HIV testing services. Geneva: WHO, 2015: 1\u2013188."},{"key":"2025101811110563000_14.3.e058098.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0192327","article-title":"Facilitators and barriers for HIV-testing in Zambia: a systematic review of multi-level factors","volume":"13","author":"Qiao","year":"2018","journal-title":"PLoS ONE"},{"key":"2025101811110563000_14.3.e058098.8","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1080\/14659891.2018.1448473","article-title":"Perceived barriers and Facilitators to uptake of HIV testing services among people who inject drugs in Vietnam","volume":"23","author":"Thi Thanh Huong","year":"2018","journal-title":"J Subst Use"},{"key":"2025101811110563000_14.3.e058098.9","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1353\/hpu.2014.0113","article-title":"HIV testing and engagement in care among highly vulnerable female sex workers: implications for treatment as prevention models","volume":"25","author":"Surratt","year":"2014","journal-title":"J Health Care Poor Underserved"},{"key":"2025101811110563000_14.3.e058098.10","unstructured":"Staveteig S , Wang S , Head SK , et al . Demographic patterns of HIV testing uptake in Sub-Saharan Africa. DHS Comparative Reports. Calverton, Maryland, USA: ICF International, 2013."},{"key":"2025101811110563000_14.3.e058098.11","first-page":"302","article-title":"An overview of recent evidence on barriers and facilitators to HIV testing","volume":"41","author":"Traversy","year":"2015","journal-title":"Can Commun Dis Rep"},{"key":"2025101811110563000_14.3.e058098.12","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2014.26.1.81"},{"key":"2025101811110563000_14.3.e058098.13","unstructured":"WHO . Consolidated guidelines on HIV testing services for a changing epidemic. Geneva, Switzerland: WHO, 2019: 1\u201312."},{"key":"2025101811110563000_14.3.e058098.14","unstructured":"WHO . WHO recommends social-network based HIV testing approaches for key populations as part of partner services package. Geneva, Switzerland: WHO, 2019."},{"key":"2025101811110563000_14.3.e058098.15","unstructured":"IAS . Differentiated service delivery for HIV: a decision framework for HIV testing services. It\u2019s time to test differently. Geneva, Switzerland: International Aids Society, 2018: 1\u201368."},{"key":"2025101811110563000_14.3.e058098.16","unstructured":"UNAIDS . Global AIDS Monitoring 2020: indicators for monitoring the 2016 political declaration on ending AIDS. Global AIDS Monitoring. Geneva, Switzerland: UNAIDS, 2020."},{"key":"2025101811110563000_14.3.e058098.17","unstructured":"WHO . WHO national policy repository. 2015 ed. Dropbox: WHO, 2020."},{"key":"2025101811110563000_14.3.e058098.18","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1016\/S0140-6736(13)61945-5","article-title":"Health post-2015: evidence and power","volume":"383","author":"Buse","year":"2014","journal-title":"Lancet"},{"key":"2025101811110563000_14.3.e058098.19","unstructured":"WHO . Consolidated ARV guidelines. Geneva, Switzerland: WHO, 2013."},{"key":"2025101811110563000_14.3.e058098.20","unstructured":"WHO . Guidelines on HIV self-testing and partner notification: supplement to consolidated guidelines on HIV testing services. Geneva, Switzerland: WHO, 2016."},{"key":"2025101811110563000_14.3.e058098.21","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1007\/s12160-012-9346-9","article-title":"AIDS-related stigma, HIV testing, and transmission risk among patrons of informal drinking places in Cape town, South Africa","volume":"43","author":"Pitpitan","year":"2012","journal-title":"Ann Behav Med"},{"key":"2025101811110563000_14.3.e058098.22","doi-asserted-by":"crossref","DOI":"10.7448\/IAS.18.1.20221","article-title":"Barriers to HIV testing and characteristics associated with never testing among gay and Bisexual men attending sexual health clinics in Sydney","volume":"18","author":"Conway","year":"2015","journal-title":"J Int AIDS Soc"},{"key":"2025101811110563000_14.3.e058098.23","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-022-12761-5","article-title":"The impact of stigma on HIV testing decisions for gay, bisexual, queer and other men who have sex with men: a qualitative study","volume":"22","author":"Iott","year":"2022","journal-title":"BMC Public Health"},{"key":"2025101811110563000_14.3.e058098.24","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0249462","article-title":"Dimensions of HIV-related stigma in rural communities in Kenya and Uganda at the start of a large HIV \u2018test and treat\u2019 trial","volume":"16","author":"Akatukwasa","year":"2021","journal-title":"PLoS ONE"},{"key":"2025101811110563000_14.3.e058098.25","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1007\/s10461-019-02771-7","article-title":"Falling short of the first 90: HIV stigma and HIV testing research in the 90\u201390\u201390 era","volume":"24","author":"Sullivan","year":"2020","journal-title":"AIDS Behav"},{"key":"2025101811110563000_14.3.e058098.26","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-018-6156-4","article-title":"Stigma reduction in relation to HIV test uptake in Low- and middle-income countries: a realist review","volume":"18","author":"Thapa","year":"2018","journal-title":"BMC Public Health"},{"key":"2025101811110563000_14.3.e058098.27","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0188890","article-title":"Can self-testing increase HIV testing among men who have sex with men: a systematic review and meta-analysis","volume":"12","author":"Zhang","year":"2017","journal-title":"PLoS ONE"},{"key":"2025101811110563000_14.3.e058098.28","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1097\/QAD.0000000000001705","article-title":"Experiences using and organizing HIV self-testing","volume":"32","author":"Qin","year":"2018","journal-title":"AIDS"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2021-058098","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T18:11:17Z","timestamp":1760811077000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2021-058098"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":28,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3,13]]},"published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1136\/bmjopen-2021-058098"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2021-058098","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3]]}}}