MAKE UP SEPT 2006


THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE                                       SEPTEMBER 2006  55

Of late we have witnessed a number of important initiatives
that aim to promote expanded screening for HIV infection.
There have been calls by public health authorities, including
the World Health Organization, for a move away from the
traditional voluntary counselling and testing (VCT) model. One
initiative currently underway in many countries, including
Botswana, is the ‘opt out’ model where patients would be
subjected to routine HIV testing unless they expressly state

that they do not wish to be tested. The Centers for Disease
Control has developed a document entitled ‘Revised
recommendations for HIV testing of adults, adolescents, and
pregnant women in health care settings’. This document
recommends that HIV testing become a routine part of medical
care for all teenagers and adults in the USA. This will have the
effect of enhancing HIV case finding and represents a major
shift to HIV testing in clinical practice in the USA. 

The rationale for this expanded screening meets many of the
criteria for an effective preventive practice intervention, in
that HIV serological tests are reliable and inexpensive,
untreated infection has serious health consequences, and
highly effective treatment is now becoming increasingly
accessible. Recent cost-effectiveness analyses have
demonstrated that HIV screening is as cost-effective as
screening interventions for other chronic diseases. 

Two articles in this issue of the Journal look at various aspects
related to testing, VCT and the stigmatisation around HIV. We
have published an article by a person living with HIV who
describes his personal experiences at the time of testing: how
he faced the stigmatisation, how it changed his life, and how
he used this life-changing event to become an advocate of
promoting VCT in order to know your status. As he says, ‘Take
action now and know your status.’ In common with other
scientific journals we have included a personal essay to
emphasise the issues at stake.

DES MARTIN

Editor, Southern African Journal of HIV Medicine

F R O M  T H E
E D I T O R

This issue of the Journal is being put to bed as the first
Botswana HIV Conference closes. The Conference, put
together by a committed group of local members of the
Botswana HIV Clinicians Society, has been an overwhelming
success – an audience of over 700, international and local
experts giving excellent talks, within a professionally run
operation. Feedback on proceedings has been very positive,
and I would like to congratulate the conference committee
and the Botswana branch on an inspired and brave
programme. I sincerely hope you repeat it in the future – the

flavour was distinctly African, the debate robust and honest,
and the clinical exposure impressive. There are rumours of the
conference being repeated, and word of mouth on the quality
of this one will ensure that the next is even bigger.
Congratulations again to Botswana, who seem to know how
to lead from the front in all areas of HIV.

FRANCOIS VENTER
President

M E S S A G E  F R O M  T H E  E X E C U T I V E

Professor Sheila Tlou, Botswana Minister of Health, Dr Francois Venter, Southern African HIV Clinicians Society, His Excellency Festus
Mogae, President of the Republic of Botswana, and Dr Kgosi Mompati, President of the Botswana branch of the SAHIVCS and
chairman of the conference committee.