Policy adoption of 2019 WHO-recommended HIV testing strategies, WHO regional office for Africa (AFRO), 2021
| AFRO subregions (countries) | Policies reviewed | Serial testing strategy | Discontinuation of tiebreaker* testing strategy | Retesting prior to ART initiation | Recommended three-test strategy† | Use of dual HIV/syphilis test‡ | No use of Western Blot |
| All (n=47) | 45 (96%) | 29 (62%) | 37 (79%) | 23 (49%) | 21 (45%) | 21 (45%) | 35 (74%) |
| Western (n=17) | 16 (94%) | 9 (53%) | 9 (53%) | 5 (29%) | 8 (47%) | 7 (41%) | 10 (59%) |
| Central (n=9) | 8 (89%) | 7 (78%) | 7 (78%) | 5 (56%) | 3 (33%) | 2 (22%) | 6 (67%) |
| Eastern (n=16) | 16 (100%) | 12 (75%) | 16 (100%) | 9 (56%) | 9 (56%) | 9 (56%) | 14 (88%) |
| Southern (n=5) | 5 (100%) | 1 (20%) | 5 (100%) | 4 (80%) | 1 (20%) | 3 (60%) | 5 (100%) |
*Use of a third assay to rule-in HIV infection.
†At the time of the review, some countries noted that they were in the process of transitioning to a three-test strategy; however, they were not included as in compliance because their national guidance and testing strategy was not yet finalised.
‡Dual HIV/syphilis RDT as the first test in ANC. Note that at the time of the review, five countries were using test outside of WHO guidance. Two countries had non-compliant algorithms (Lesotho and Zambia) and three countries (Liberia, Madagascar and Uganda) were also using the test among key populations and partners of pregnant women. As of 2023, however, the dual test is recommended among key populations and those with high ongoing risk.
ANC, antenatal care; RDT, rapid diagnostic test.