Overall, building the capacity of health care personnel in identifying and handling AHD cases was considered the most important factor in addressing AHD, at 59%, followed by intensified support interventions for patient adherence to antiretroviral therapy, at 52%. Expanding access to diagnostic tools and services ranked third, at 45%, tied with government policy for AHD.

59%

Building the capacity of health care personnel in identifying and handling AHD cases

52%

Intensified support interventions for patient adherence to antiretroviral therapy

45%

Expanding access to diagnostic tools and services /
Government policy for AHD

A quarter of respondents attributed the persistently high levels of AHD to weak and poorly targeted AHD interventions, while 18% mentioned low access to and capacity for diagnosis and monitoring. “[There is] poor access and lack of global support for CD4 testing, which is the gateway to the AHD package of care, as well as a lack of focus on, and clear guidance from, governments,” said a respondent from Zimbabwe.

Now, the COVID-19 pandemic could further exacerbate the situation. A majority — 90% — of professionals said they expected AHD numbers to surge, with 42% citing limited access to health care facilities, commodities, and services as major factors.

90%

A little over half of respondents said AHD is typically diagnosed through CD4 cell count testing and clinical staging as indicated by viral load, although results varied across regions and income levels.

A little over half of respondents (57%) say that AHD is typically diagnosed through the WHO-recommended combination of WHO clinical staging and CD4 testing in their focus country. The remainder of respondents find that in their focus country, AHD is typically diagnosed through either approach (18%), CD4 testing only (14%), clinical staging only (8%) or not at all (3%)