The November 2015 edition of the WHO consolidated guidelines on the use of antiretrovirals (ARVs) updates the 2013 edition following an extensive review of evidence undertaken in 2015. These new recommendations support initiation of antiretroviral treatment (ART) in all adults, adolescents, and children with HIV, regardless of CD4 cell count or disease stage. For the first time, the guidance includes recommendations specifically for adolescents (10 to 19 years old), covering when to begin ART and approaches for service delivery. The 2015 guidelines include 10 new recommendations, among them:
- A differentiated care framework for addressing the diverse needs of people living with HIV
- Alternative strategies for community-based ART delivery to accommodate the growing number of people on treatment
- Principles for improving quality of care and providing people-centered care.
The updated guidelines also include recommendations on service delivery to support implementation (“the how” of providing ARVs), organized according to the continuum of HIV testing, prevention, treatment, and care. For the first time, the guidelines include “good practice statements” on interventions whose benefits substantially outweigh potential harms. The guidelines also articulate the need to expand access to HIV testing, prevention, treatment, and care in settings and populations with the highest HIV burden. Meeting this need requires concerted efforts to support long-term adherence to ARV drugs, and to eliminate stigma, discrimination, and barriers to HIV services.