World Aids Day — It is vital to be vigilant on quality as we rush to test people for HIV

The theme for this year’s World Aids Day is ‘Equalise and Integrate to End Aids’. One aspect in which more equality is needed is between the quality of HIV testing services and aiming to test as many people as possible, argues René Sparks.
As we approach World Aids Day on 1 December, healthcare providers will be offering HIV screening and testing as part of a comprehensive health service.
The theme for this year’s World Aids Day is: ‘Equalise and Integrate to End Aids’.
One aspect in which more equality is arguably needed is between the quality of HIV testing services and aiming to test as many people as possible.
Progress against targets?
It is estimated that 13.9% of South Africa’s population is living with HIV and that the absolute number of people living with HIV in the country has increased from 3.8 million in 2002 to 7.8 million in 2021. This number has continued to rise since the death rate has declined much more rapidly than the rate of new HIV infections.
The most widely used measure of a country’s HIV response in recent years has been the UNAids 90-90-90 targets. These aim at 90% of people living with HIV knowing their status, 90% of those diagnosed started on ARVs, and 90% of those on ARVs being virally suppressed by 2020. The goal post has now shifted to 95-95-95.
Earlier this year, health minister Dr Joe Phaahla said that in South Africa we are on 94-78-89.
This indicates that we are close to reaching the first 95. It also suggests that our HIV testing efforts have generally been a success, including the introduction of HIV Rapid Testing and HIV Self Screening as HIV testing models. But, as we collectively meet these targets, it is important to focus on the quality of HIV rapid testing to ensure that we align with HIV testing standards.
Focus on quality
The quality of HIV Rapid testing to some extent depends on laboratories, but often it is driven by HIV counsellors and service delivery NGOs. As a public health professional managing the National HIV Testing Quality Assurance and Laboratory Systems Strengthening programme, seconded to the Department of Health through Sead Consulting, it is my job to support NGOs, the Department of Health, and the Department of Correctional Services in implementing quality assurance of HIV Testing and in improving the laboratory systems between health facilities and the National Health Laboratory Service.
As someone who has worked in ...