Universal HIV testing in developing countries with high levels of infection could prove valuable in tackling the spread of the pandemic, former President of United States Bill Clinton said on Tuesday.
He stressed that this type of intervention was better suited to countries where there was no discrimination against HIV-positive people and suitable treatment was readily available.
"I think there needs to be a total rethinking of this testing position in the AIDS community, and a real push for this," the former president said in a statement.
Clinton noted that he supported the Southern African kingdom of Lesotho, the first country to introduce universal testing of all its 2.2 million citizens, of whom 27 percent are HIV-positive.
The World Health Organization already recommends the routine offer of an HIV test if antiretroviral treatment is available in all clinical and community health care settings.
The US Centers for Disease Control and Prevention is in the process of revising its guidance on HIV testing, to move to a practice of routinely offering the test in all health care settings, together with a recommendation for annual testing for people with risk behaviours for HIV infection.
However, calls for a move towards universal testing were criticised in a recent article in the Bulletin of the World Health Organization, in which Stuart Rennie and Frieda Behets of the University of North Carolina, USA, warned that protections against discrimination and stigma were still more theoretical than real, despite growing access to treatment, and that policymakers must recognise that programmes to reduce stigma remain underfunded.
Rennie S & Behets F. Desperately seeking targets: the ethics of routine HIV testing in low-income countries. Bulletin of the World Health Organization 84: 52-57, 2006.