title: Can trained lay providers perform HIV testing services? A review of national HIV testing policies.
abstract: BACKGROUND
  Only an estimated 54% of people living with HIV are aware of their status. Despite progress scaling up HIV testing services (HTS), a testing gap remains. Delivery of HTS by lay providers may help close this testing gap, while also increasing uptake and acceptability of HIV testing among key populations and other priority groups.
  
  
  METHODS
  50 National HIV testing policies were collated from WHO country intelligence databases, contacts and testing program websites. Data regarding lay provider use for HTS was extracted and collated. Our search had no geographical or language restrictions. This data was then compared with reported data from the Global AIDS Response Progress Reporting (GARPR) from July 2015.
  
  
  RESULTS
  Forty-two percent of countries permit lay providers to perform HIV testing and 56% permit lay providers to administer pre-and post-test counseling. Comparative analysis with GARPR found that less than half (46%) of reported data from countries were consistent with their corresponding national HIV testing policy.
  
  
  CONCLUSIONS
  Given the low uptake of lay provider use globally and their proven use in increasing HIV testing, countries should consider revising policies to support lay provider testing using rapid diagnostic tests.
authors.affiliation: Griffith University School of Medicine, Griffith University, Gold Coast, QLD, Australia. deflynn75@gmail.com.|, 8 Bellevue St, Chatswood West, NSW, 2067, Australia. deflynn75@gmail.com.
authors.forename: David E
authors.initials: DE
authors.lastname: Flynn
authors.affiliation: HIV Department, World Health Organization (WHO), Geneva, Switzerland.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Johnson
authors.affiliation: Essential Medicines and Health Products, World Health Organization (WHO), Geneva, Switzerland.
authors.forename: Anita
authors.initials: A
authors.lastname: Sands
authors.affiliation: Global Health Bureau: Office of HIV/AIDS, United States Agency for International Development (USAID), Washington, DC, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Wong
authors.affiliation: HIV Department, World Health Organization (WHO), Geneva, Switzerland.
authors.forename: Carmen
authors.initials: C
authors.lastname: Figueroa
authors.affiliation: HIV Department, World Health Organization (WHO), Geneva, Switzerland.
authors.forename: Rachel
authors.initials: R
authors.lastname: Baggaley
mesh_terms: D003150:Community Health Workers; D003376:Counseling / Q000379:methods; D003955:Diagnostic Tests, Routine; D005843:Geography; D015658:HIV Infections / Q000175:diagnosis*; D006679:HIV Seropositivity / Q000175:diagnosis*; D006291:Health Policy; D006801:Humans; D038622:Internationality; D008403:Mass Screening; D011369:Professional-Patient Relations; D014342:Truth Disclosure
keywords: Community health workers; HIV policy; HIV testing; Lay providers