An implementer's guide to introducing HIV viral load monitoring
HIV viral load (VL) testing has been the gold standard for monitoring the response to antiretroviral therapy (ART) in high-income settings for many years and is increasingly recognized as an important tool for the management of ART in resource-limited settings. Benefits of VL monitoring include the ability to diagnose poor adherence and treatment failure early, prevent unnecessary switches to second line ART and to allow optimization of treatment response in order to avoid development of resistance and prevent transmission.1,2,3 Guidelines for ART management issued by the World Health Organization (WHO) have recognized the importance of VL monitoring since 2003 and routine VL monitoring is now strongly recommended as the monitoring strategy of choice.
This toolkit is designed to provide implementers with a set of tools to aid in implementation of VL monitoring including aspects related to sample preparation, activities for clinical and counselling staff, and education and empowerment of the patients themselves. The tools and algorithms form a basis for implementation, but will need to be adapted to the local context.
A training pack for clinicians and counsellors is also attached in Annexes 4 and 5 that incorporate these key components.