Important note: Information in this article was accurate in 2008. The state of the art may have changed since the publication date.
Sunday Times (Johannesburg) - November 26, 2008
The study used computer modelling to determine the effects of testing every person over 15.
According to Reuters, the study, published in the medical journal Lancet, "used data from South Africa as a test case for a generalised epidemic in their model, which assumed all HIV transmission was through heterosexual sex."
The results indicated that voluntary screening in which at least 90% of the population took part, and immediate treatment for people testing positive, could reduce HIV transmission by more than 95% within 10 years.
This might seem a clear argument for universal HIV testing, but the WHO cautions that implementing the scheme might not be feasible because of poor healthcare infrastructure.
This is demonstrated by a universal HIV testing scheme in Lesotho. According to AFP, that campaign, which started in 2005, aimed to test 1.3 million people, but by August last year had only tested 25,000.
AFP reports that a study issued last week by Human Rights Watch and the AIDS and Rights Alliance for Southern Africa indicated that "thousands of counselors were supposed to receive training under the scheme, while support services for people with HIV were meant to be expanded, but those efforts were largely sidelined due to poor funding and administrative failures."
Testing and treatment would need to be carefully controlled. A researcher warned in the Lancet that "at its worst, the strategy will involve over-testing, over-treatment, side effects, resistance, and potentially reduced autonomy of the individual in their choices of care."
Further research is recommended, with the report's authors concluding that "Universal voluntary HIV testing and immediate ART, combined with present prevention approaches, could have a major effect on severe generalised HIV/AIDS epidemics. This approach merits further mathematical modelling, research, and broad consultation."
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