Viral load testing is critical for two reasons. First, it identifies people who are having problems regularly taking their medicines, and can be used to trigger additional adherence counseling. Second, it identifies people who have indeed developed drug resistance and need to be switched to another treatment regimen. Viral load testing helps avoid unnecessarily switching patients to more expensive drugs and reducing future treatment options. It also helps identify patients who are taking their drugs but no longer benefiting from a given combination because of resistance. Increased access to viral load monitoring can help people stay on antiretroviral combinations as long as possible, and help stave off resistance.

With approximately 17,000 new HIV infections estimated for 2016. With an estimated 114,638 PLHIV; 17,224 were registered at 21 ART clinics, while 8,888 enrolled for treatment, till end December, 2016. The VL testing facilities are restricted to only three [3] major cities namely Karachi, Lahore and Islamabad, which in itself reflects the access of people in need to RVLT. HIV Viral load and CD4 cell count are the two surrogate markers of antiretroviral treatment (ART) responses and HIV disease progression that have been used for decades to manage and monitor HIV infection.

VL is the most important indicator of initial and sustained response to ART and should be measured in all HIV infected patients at entry to care, at initiation of therapy and on regular basis thereafter. Routine viral load monitoring is still the exception rather than the rule in resource-limited settings like Pakistan owing to a number of barriers to implementation. The WHO and National ART Guidelines illustrate a need for conducting periodic CD-4 and VL tests, however non scarcity of resources hinders these guidelines to be implemented but still this depends how many PLHIV have access to the testing facilities. Viral load testing, which is a crucial test for monitoring patient response to treatment of AIDS, is currently available in only three cities. Limited RVLT facilities render most of the PLHIV not to access RVLT due to financial constraints and distances involved to reach the services.

Keeping same in mind the APLHIV-Pakistan is of the opinion that there is dire need that the community people are well educated about the need and importance of RVLT to generate a demand for expansion of RVLT services and it also illustrate a need for an aggressive advocacy campaign for expansion of the services. The Association of people living with HIV {APLHIV]-Pakistan along with its networks of Positive Females [POFEN], Drug User’s Network [DUNE] and Y-Chapter launched an initiative with support of ITPC to create and enhance education about  need and importance of RVLT among community members to create a demand and to launch advocacy campaign for expansion of the said services. Under this project the APLHIV is focusing on following Three [3] components: –

  1. Educating Community Members On Need 7 Importance of RVLT
  2. Launching of Community Support Groups To Act As Peers and Advocates For Treatment Adherence & Expansion of RVLT.
  3. Advocacy For Expansion of RVLT

The APLHIV has undertaken Five [5] training sessions so far involving 165 community people across country and in next phase Advocacy skill building will be focused.