doi: 10.56294/shp202351
SHORT COMMUNICATION
HIV testing in Argentina: legal advances and persistent challenges
La prueba de VIH en Argentina: avances legales y desafíos persistentes
Lucía Daniela Medeot Villegas1 *, Romina Leardi1 *
1Universidad Abierta Interamericana, Facultad de Medicina y Ciencias de la Salud, Carrera de Medicina. Buenos Aires, Argentina.
Citar como: Medeot Villegas LD, Leardi R. HIV testing in Argentina: legal advances and persistent challenges. South Health and Policy. 2023; 2:51. https://doi.org/10.56294/shp202351
Enviado: 10-08-2022 Revisado: 02-02-2023 Aceptado: 17-06-2023 Publicado: 18-06-2023
Editor: Dr. Telmo Raúl
Aveiro-Róbalo
Autor para la correspondencia: Lucía Daniela Medeot Villegas *
ABSTRACT
In recent decades, Argentina has developed a comprehensive health policy for testing for the Human Immunodeficiency Virus (HIV), adapting to the social and epidemiological changes in the country and in Latin America. Since the passing of the National AIDS Law (No. 23.798) in 1990, and especially after its update with Law 27,675 in 2022, free, voluntary, confidential and non-prescription access to HIV testing was consolidated in both the public and private systems. This legislation promoted an approach based on human rights, a gender perspective, diversity and the elimination of structural barriers. The Ministry of Health promoted strategies such as rapid testing, which offered results in minutes and was applied in community and mobile settings. These actions, accompanied by national campaigns and the strong involvement of social organisations, facilitated early detection and the immediate start of treatment. However, challenges persisted related to stigma, lack of information, regional inequalities and access in key populations. Compared to other Latin American countries, Argentina led the way in inclusive regulations, while many still maintained restrictive requirements for testing. Argentina also adhered to global targets such as UNAIDS’ 95-95-95 and the “Treatment for All” approach, standing out as a regional example. However, the success of its policies depended on their effective territorial implementation, continuous training and sustained political commitment to consolidate a stigma-free testing culture.
Keywords: Testing; Rights; Confidentiality; Public Policy; HIV.
RESUMEN
En las últimas décadas, Argentina desarrolló una política sanitaria integral para la prueba del Virus de Inmunodeficiencia Humana (VIH), adaptándose a los cambios sociales y epidemiológicos del país y de América Latina. Desde la sanción de la Ley Nacional de Sida (N.º 23.798) en 1990, y especialmente tras la actualización con la Ley 27.675 en 2022, se consolidó el acceso gratuito, voluntario, confidencial y sin orden médica a la prueba de VIH, tanto en el sistema público como privado. Esta normativa promovió un enfoque basado en derechos humanos, perspectiva de género, diversidad y eliminación de barreras estructurales. El Ministerio de Salud impulsó estrategias como el test rápido, que ofreció resultados en minutos y se aplicó en espacios comunitarios y móviles. Estas acciones, acompañadas por campañas nacionales y el fuerte protagonismo de organizaciones sociales, facilitaron la detección temprana y el inicio inmediato del tratamiento. No obstante, persistieron desafíos relacionados con el estigma, la falta de información, desigualdades regionales y el acceso en poblaciones clave. En comparación con otros países latinoamericanos, Argentina lideró en normativas inclusivas, mientras que muchos aún mantuvieron exigencias restrictivas para el testeo. Argentina también adhirió a metas globales como el 95-95-95 de ONUSIDA y al enfoque “Tratamiento para todos”, destacándose como ejemplo regional. Sin embargo, el éxito de sus políticas dependió de su
efectiva implementación territorial, de la capacitación continua y del compromiso político sostenido para consolidar una cultura del testeo libre de estigmas.
Palabras clave: Testeo; Derechos; Confidencialidad; Políticas Públicas; VIH.
BACKGROUND
The Human Immunodeficiency Virus (HIV) continues to be a significant public health problem worldwide. In Latin America, particularly Argentina, health responses have evolved in recent decades, adapting to new social, epidemiological, and technological realities.(1,2) One of the key pillars of HIV control is access to accessible, free, confidential, and timely diagnostic tests.(3,4,5) HIV testing not only allows early diagnosis and immediate initiation of treatment but is also a crucial element for prevention, epidemiological monitoring, and the promotion of the human rights of people living with the virus.(6)
For more than two decades, HIV testing in Argentina has been free and confidential, both in the public and private systems, in compliance with National Law No. 23.798 (AIDS Law), enacted in 1990 and updated in 2022 with Law 27.675 (“National Law on Comprehensive Response to HIV, Viral Hepatitis, STIs and Tuberculosis”).(7)
This legal framework establishes that everyone has the right to know their HIV status without discrimination or stigmatization. It also recognizes the right to take the test voluntarily, without needing a medical order, and to receive pre-and post-test counseling.(8)
The enactment of Law 27,675 marked a significant advance in Argentina's health approach to HIV. This law establishes a comprehensive and intersectoral response, incorporates a human rights, gender, and diversity perspective, and promotes the elimination of structural barriers to access to diagnosis and treatment.(8)
In addition, the law expressly prohibits HIV testing as a requirement to enter a job, an educational institution, or to access social or health benefits, which represents a key protection against structural discrimination.
One of the main strategies implemented by the Argentine Ministry of Health has been promoting rapid HIV testing, which allows results to be obtained in less than 20 minutes.(9) These tests, validated by ANMAT, can be performed in community clinics, health fairs, primary care centers, hospitals, mobile units, and civil society organizations.
Despite regulatory and programmatic advances, there are still several barriers to universal access to HIV testing.
In Latin America, most countries are committed to achieving the UNAIDS 95-95-95 targets by 2030: 95% of people with HIV know their diagnosis, 95% of those who know their status receiving treatment, and 95% of those on treatment achieving an undetectable viral load.(10)
However, there are significant inequalities between countries. Some, such as Chile, Uruguay, Brazil, and Argentina, have made significant progress, while others face deeper structural barriers.
Argentina is among the most advanced countries in the region in terms of regulatory framework and free access to testing.(11) Unlike other Latin American countries where medical orders are still required, or mandatory testing practices persist (e.g., in the armed forces or migration), Argentina has actively promoted voluntary and confidential testing.
The country has also joined regional strategies such as “Treatment for All” (Test & Treat), which seeks to initiate antiretroviral treatment immediately after diagnosis, regardless of CD4 count.(11)
One key factor in the success of Argentina's HIV policies has been the strong role played by social organizations, both in political advocacy and in the territorial implementation of testing strategies.(8)
Although Argentina has demonstrated political and technical commitment in its response to HIV, the challenge remains to reach those who still do not know their diagnosis and to strengthen the links in the health system to ensure continuity of treatment.
HIV testing is much more than a diagnostic tool: it is a gateway to comprehensive health, to the protection of rights, and to the elimination of the stigma that still weighs on those living with the virus. In Argentina, public policies have made significant progress in guaranteeing free, confidential, and non-discriminatory access to the test, which aligns with international and regional standards.(3,7)
However, the success of these policies depends mainly on their practical implementation in the territory, the training of health personnel, sustained political commitment, and community empowerment.
In a Latin American context marked by inequalities, setbacks in sexual and reproductive rights, and economic crises, Argentina is a positive example but still faces pending challenges. Consolidating a culture of voluntary testing, free of stigma, is a collective task that requires political will, investment, and active participation of all social sectors.
BIBLIOGRAPHIC REFERENCES
2. Kaai S, Bullock S, Burchell AN, Major C. Factors that affect HIV testing and counseling services among heterosexuals in Canada and the United Kingdom: An integrated review. Patient Education and Counseling. 2012; 88(1):4-15. https://doi.org/10.1016/j.pec.2011.11.011.
3. Morales A, Espada JP, Orgilés M. Barreras hacia la prueba de detección del VIH en adolescentes en España. Psychosocial Intervention. 2016; 25(3):135-141. https://dx.doi.org/10.1016/j.psi.2016.06.002.
4. Bradley H, Tsui A, Kidanu A. Client Characteristics and HIV Risk Associated with Repeat HIV Testing Among Women in Ethiopia. AIDS Behav. 2011; 15:725-733. https://doi.org/10.1007/s10461-010-9765-1
5. Brooks RA, Lee S-J, Stover GN, Barkley TW. HIV testing, perceived vulnerability and correlates of HIV sexual risk behaviours of Latino and African American young male gang members. International Journal of STD & AIDS. 2011;22(1):19-24. doi:10.1258/ijsa.2010.010178
6. Hyden C, Allegrante JP, Cohall AT. HIV Testing Sites’ Communication About Adolescent Confidentiality: Potential Barriers and Facilitators to Testing. Health Promotion Practice. 2013; 15(2):173-180. doi:10.1177/1524839913499347
7. Kurth, A.E., Lally, M.A., Choko, A.T., Inwani, I.W. and Fortenberry, J.D. (2015), HIV testing and linkage to services for youth. Journal of the International AIDS Society, 18: 19433. https://doi.org/10.7448/IAS.18.2.19433
8. Trieu S L. Partner communication and factors associated with the decision to obtain an HIV test among Chinese/Chinese American community college students in Northern California. Dissertation Abstracts International: Section B: The Sciences and Engineering 2008; 69 (4-B): 2279, 2024.
9. Sanabria-Mazo JP, Hoyos-Hernández PA, Bravo F. Psychosocial factors associated with HIV testing in Colombian university students. Acta Colombiana de Psicología. 2020; 23(1): 158-168. https://doi.org/10.14718/acp.2020.23.1.8
10. Spielberg F, Kurth A, Gorbach P M, Goldbaum G. Moving from apprehension to action: HIV counseling and testing preferences in three at-risk populations. AIDS Education and Prevention. 2005; 13(6). https://doi.org/10.1521/aeap.13.6.524.21436
11. Kall MM, Ruth D. S, Valerie CD. Late HIV Diagnosis in Europe: A Call for Increased Testing and Awareness among General Practitioners. European Journal of General Practice. 2012; 18(3):181–86. doi:10.3109/13814788.2012.685069.
FINANCING
None.
CONFLICT OF INTEREST
None.
AUTHORSHIP CONTRIBUTION
Conceptualization: Lucía Daniela Medeot Villegas, Romina Leardi.
Data curation: Lucía Daniela Medeot Villegas, Romina Leardi.
Formal analysis: Lucía Daniela Medeot Villegas, Romina Leardi.
Research: Lucía Daniela Medeot Villegas, Romina Leardi.
Methodology: Lucía Daniela Medeot Villegas, Romina Leardi.
Project Management: Lucía Daniela Medeot Villegas, Romina Leardi.
Resources: Lucía Daniela Medeot Villegas, Romina Leardi.
Software: Lucía Daniela Medeot Villegas, Romina Leardi.
Supervision: Lucía Daniela Medeot Villegas, Romina Leardi.
Validation: Lucía Daniela Medeot Villegas, Romina Leardi.
Visualization: Lucía Daniela Medeot Villegas, Romina Leardi.
Writing - original draft: Lucía Daniela Medeot Villegas, Romina Leardi.
Writing - proofreading and editing: Lucía Daniela Medeot Villegas, Romina Leardi.