Several countries are at different stages of scaling up HIV viral load testing and uptake of results for patient management. Viral load testing is the gold standard and the most effective method for monitoring of people on antiretroviral therapy (ART) living with HIV. For countries to achieve the UNAIDS target of 90% viral suppression of patients on ART, increased access to viral load testing and utilization of results for patient management with adherence counselling would be critical for monitoring patients. Several barriers to access and uptake of HIV viral load results have been identified within the pre-analytical, analytical and post analytical phase of the viral load cascade and include weaknesses in demand creation, sample referral systems, procurement, optimization of testing capacity, return and uptake of results, and monitoring and evaluation of the cascade for improvements.
Recognizing these barriers to viral load scale up, a group of partners and stakeholders (World Health Organization, African Society for Laboratory Medicine, Centers for Disease Control and Prevention, United States Agency for International Development, Clinton Health Access Initiative, Médecins Sans Frontières, Global Fund, Riders for Health, Clinical Laboratory Standards Institute) convened, identified and developed tools that would assist programs in scaling up viral load testing and uptake of results.