In Nepal an HIV case was first detected in 1988. The prevalence of HIV in adults is 0.17 percent in 2016. The National Centre for AIDS and STD Control (NCASC) has taken the lead role in lowering the rate of HIV infections throughout Nepal. HIV prevalence has reduced significantly during the last decade due to effective targeted interventions among key populations and greater enrolment in treatment. The NCASC, with technical assistance of key stakeholders, has been able to follow the “test and treat approach” to reach the global target (90-90-90).
In order to achieve optimal treatment outcomes, it is necessary to follow standardized treatment protocols and ensure highest levels of adherence to treatment (>95%) and to periodically update them based on emerging evidence. Since the formulation of the first ART guideline in the country in 2006, a number of new xxii National HIV Testing and Treatment - Guidelines 2017 developments have occurred in the field of HIV. The 2013 WHO Consolidated Guidelines on the Use of ART for Preventing and Treating HIV Infection followed a public health approach. The aims of the guideline are to ensure universal access to ART, use of fixed drug combinations, strategic and rational use of medicines, and to optimize existing health care systems to ensure long-term sustainability of HIV treatment activities. The guidelines clearly state that “implementation of the recommendations in these guidelines should be informed by local context, including HIV epidemiology, availability of resources, the organization and capacity of the health system and anticipated costeffectiveness issues.” The national ART guidelines for the country were revised in March 2014 in line with the 2013 WHO guidelines. Based on evidence from recent studies (African Temprano and START and other large observational studies), WHO revised the consolidated guidelines on “The Use of ARV Drugs for Treating and Preventing HIV Infection, Recommendation for a Public Health Approach” in 2016. The current revision of the 2014 national guidelines is based on evidence in the 2016 WHO guidelines and recommendations of the Technical Working Group (TWG) meetings, held in September 2016, and the National Workshop on Revision of Guidelines, held in December 2016.
The target audiences are the national AIDS programme managers, partners involved in HIV care and treatment services, and organizations providing technical and financial support to HIV care and treatment programmes in Nepal.
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