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A review of HIV testing and counseling policies and practices in the Eastern Mediterranean Region.

机译：东地中海东部艾滋病毒检测和咨询政策及实践综述。

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OBJECTIVE: To review HIV testing and counseling policies and practices in the World Health Organization's (WHO) Eastern Mediterranean Region. METHODS: We reviewed gray and published literature on HIV testing policies and practices in the 22 countries of the Eastern Mediterranean Region, including surveillance, monitoring and evaluation reports. Missing or unclear information was clarified by telephone interviews of key informants. Field observations were conducted in four countries. RESULTS: Of reported diagnostic HIV tests conducted in the Eastern Mediterranean Region from 1995 to 2008, 59.3% were carried out on migrant workers. Only 4.0% were carried out on key populations at higher risk for HIV and 8.1% were conducted in sexually transmitted infection, tuberculosis and antenatal care services. The largest proportions of HIV-positive cases identified were among key populations at higher risk (23.4%) and in sexually transmitted infection, tuberculosis and antenatal care services (17.5%). Mandatory testing was the most common approach to identifying HIV-positive cases, yet most policy documents reviewed identified voluntary counseling and testing as a key intervention for prevention, care and treatment. Provider initiated testing and counseling was rarely considered. HIV testing strategies are cumbersome, as they require central laboratory-based Enzyme Linked Immuno-Sorbant Assay (ELISA) and/or Western Blot confirmation in most countries presenting barriers to receiving results. CONCLUSION: Although policies in the Eastern Mediterranean Region include a mix of mandatory and voluntary HIV testing, mandatory testing predominates, especially for migrant and foreign workers and key populations at higher risk of HIV. There is a paucity of programs providing voluntary testing. Strategies to enhance access to true voluntary HIV testing and counseling services are urgently needed, particularly targeting key populations at higher risk.
机译：目的：审查世界卫生组织（世卫组织）东地中海地区的艾滋病毒检测和咨询政策和实践。方法：我们在东地中海东部地区22个国家的艾滋病毒检测政策和实践中审查了灰色和公布的文献，包括监测，监测和评估报告。通过关键信息人的电话采访阐明了缺失或不清楚的信息。现场观察在四个国家进行。结果：1995年至2008年东部地中海在东部地中海地区进行的诊断艾滋病毒检测，59.3％在移民工人进行。只有4.0％的关键群体对艾滋病毒的风险较高，8.1％在性传播感染，结核病和产前护理服务中进行。确定的艾滋病毒阳性病例的最大比例是风险较高（23.4％）和性传播感染，结核病和产前护理服务（17.5％）的关键群体中。强制性检测是识别艾滋病毒阳性案件的最常见方法，但大多数政策文件审查了确定的自愿咨询和测试作为预防，护理和治疗的关键干预。提供商开始测试和咨询很少考虑。艾滋病毒检测策略是麻烦的，因为它们需要中央实验室的酶联免疫吸附剂测定（ELISA）和/或Western印迹确认，在大多数国家呈现接受结果的障碍。结论：虽然东地中海地区的政策包括强制性和自愿艾滋病毒检测的混合，特别是用于移民和外国工人的强制性检测，特别是艾滋病毒风险较高的农民工和关键群体。缺乏提供自愿测试的计划。加强对真正自愿艾滋病检测和咨询服务的策略是迫切需要的，特别是以更高的风险为主人群。

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