HIV is treatable, but treatment can only begin when a person knows their status. In Timor-Leste, getting an HIV test is not always straightforward. Long distances from health facilities, difficult roads, limited transport, shortages of trained healthcare workers, and fear of stigma can all prevent people from seeking a test.
These challenges are often greater in rural and underserved communities, where attending an appointment may require a long and costly journey. Some people may also delay testing because they are worried about how they will be treated if the result is positive. Maluk Timor’s 2025 Annual Impact Report identifies low testing rates, late diagnosis, stigma and access to ongoing treatment as continuing challenges.
Making HIV testing more accessible is therefore about more than increasing the number of tests available. It means bringing services closer to communities, making testing a normal part of routine healthcare and ensuring anyone who receives a positive result can move quickly into treatment and ongoing support.
Bringing HIV testing closer to Timorese communities
Maluk Timor works alongside Timor-Leste’s Ministry of Health to strengthen HIV prevention, testing and treatment. Its dedicated HIV Program includes an HIV centre in Dili, while also supporting healthcare workers and services that help people access high-quality care.
When testing depends entirely on someone reaching a specialist facility, distance can become a major barrier. Making testing available through local healthcare services and community-based systems reduces the need for people to make a complex journey before they can learn their status. It can also make follow-up easier if counselling, treatment or further testing is required.
This approach reflects Maluk Timor’s wider work to strengthen healthcare in Timor-Leste. Rather than creating services that sit separately from the national health system, Maluk Timor works with local doctors, nurses, midwives and community healthcare workers to improve skills and support care that can continue over the long term.
Familiar healthcare settings can also help testing feel like a normal part of looking after your health. This matters when people living with HIV may experience stigma or discrimination. A welcoming, confidential service can make it easier for someone to ask questions, agree to testing and return for care.
Why receiving a diagnosis earlier matters
HIV may not cause obvious symptoms for some time, so a person cannot know their status based on how they feel. Testing creates the opportunity to diagnose HIV earlier, begin treatment and monitor whether that treatment is working.
For someone who receives a positive result, the next step should not be left uncertain. Testing needs to be linked with clear information, counselling, treatment and follow-up. Maluk Timor supports people from diagnosis through antiretroviral treatment, viral load monitoring and ongoing care.
The results reported in 2025 show why that connection matters. At the clinics supported by Maluk Timor:
- 95% of newly registered people living with HIV started or continued treatment.
- 90% of patients receiving treatment for more than six months achieved viral suppression.
- 89% of pregnant women living with HIV had safe viral load levels during late pregnancy.
These outcomes require more than the initial test. Medicines need to remain available, healthcare workers must provide clear advice, and patients need to feel safe returning for appointments and asking for support.
Making HIV screening part of routine antenatal care
One of the most effective ways to improve access is to offer testing through healthcare services people already use. Antenatal care provides an important opportunity to do this.
By integrating HIV and syphilis testing into routine pregnancy appointments, healthcare workers can identify infections earlier and connect women with treatment more quickly. Earlier diagnosis and treatment help protect the mother’s health while reducing the risk of HIV being transmitted to her baby during pregnancy, birth or breastfeeding.
The World Health Organization’s guidance on preventing mother-to-child transmission includes antenatal testing, prompt treatment and ongoing follow-up among the services needed to prevent transmission of HIV, syphilis and hepatitis B. Maluk Timor’s work on preventing mother-to-child transmission in Timor-Leste supports this approach by helping make testing and treatment part of coordinated maternal healthcare.
Routine screening is particularly important for women who might not otherwise seek a separate HIV test. Offering it during an existing appointment removes an additional journey and can reduce the sense that HIV testing is unusual or shameful.
Maluk Timor’s Maternal and Child Health Program also works to improve access to antenatal services, especially where distance, infrastructure and limited health information affect whether women receive care during pregnancy. Connecting these services helps healthcare teams respond to the needs of the mother and baby together.
Giving healthcare workers the skills to respond
Accessible testing only works when healthcare workers have the knowledge and confidence to support the person being tested. They need to explain the process clearly, protect confidentiality, provide sensitive counselling and connect someone with appropriate treatment.
Maluk Timor supports healthcare professional development across the country, including training related to infectious diseases such as HIV and tuberculosis. In 2025, an infectious disease training package was piloted with 27 doctors, nurses, pharmacists, midwives and laboratory staff from Dili.
The practical training used case studies, role plays, games and group discussions to strengthen diagnosis, communication and treatment counselling. This helps healthcare workers recognise possible infections earlier, speak with patients more confidently and make better decisions in primary healthcare settings.
Training also supports continuity of care. Someone diagnosed with HIV may need help understanding treatment, taking medication consistently, attending follow-up appointments and completing viral load testing. When local healthcare workers have the right tools and guidance, they are better placed to provide that support without every part of care depending on a small number of specialists.
Earlier testing creates more opportunities for care
Making HIV testing more accessible means meeting people where they are. It means offering testing through local and routine healthcare services, connecting diagnosis with treatment and ensuring healthcare workers can provide respectful, confidential support.
This work is helping more people in Timor-Leste learn their status earlier and receive care closer to home. It is also strengthening the healthcare system so testing, treatment and follow-up can become more consistent across communities.
When you support Maluk Timor, you help fund the doctors, nurses, counsellors, training and practical systems needed to deliver HIV care. Every contribution helps more people access confidential testing, begin treatment and receive the ongoing support they need to live well.