Voluntary Counselling and Testing (VCT) for HIV Prevention
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VCT provides the opportunity for people to know
their HIV status with quality counseling support to help
them cope with a positive or a negative test result. The
majority of adult populations are HIV negative, even
in high HIV prevalence settings. Knowing one is HIV
negative can serve as a strong motivating factor to
remain negative, particularly for those who may
otherwise assume it is too late to adopt safer sexual
practices. For people who test positive, while VCT
services can link them to options for treatment if and
where they exist, and to care and support, just as
important, it allows for adoption of preventive
measures. For some, self-protection is a stronger
motivator for safer sex than the need to protect others;
for others, the responsibility to avoid spreading the
virus is itself the critical motivator. Both contribute to
HIV prevention.
By knowing one's positive status, HIV positive individuals may become more motivated to adopt a
more healthy lifestyle that improves their health status
and slows the progression from HIV infection to
symptomatic HIV disease and full blown AIDS – for
example, avoiding further risks of infection with other
viral strains and STIs, seeking early treatment for
opportunistic and HIV/AIDS related infections, eating
healthy food, avoiding tobacco and reducing stress. Knowing one is HIV positive also provides an
opportunity to protect sexual partners and to plan for
the future from an informed position - deciding on
marriage and on child bearing, and preparing children
and family for the progression of disease and death.
Today, there are many HIV positive people who are
living healthy and positive lives. They serve as strong
and effective HIV/AIDS advocates and also provide
valuable support and motivation for others infected
with HIV and affected by the epidemic.
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VCT Service Delivery Models When responding to the needs of specific populations, including young people and pregnant women, the VCT
service package and delivery mechanism should be designed to best respond to the client’s needs, vulnerabilities and
preferences. The following are service delivery options that have been shown to be effective for VCT: -
- Free-standing sites: facilities set up solely to provide VCT services
- VCT services integrated with other health services (such as family planning, maternal care, STI clinics,
adolescent/youth sexual and reproductive health services, drug rehabilitation clinics, general outpatient
clinics and in-patient care)
- VCT services provided within already established non-health locations and facilities (like youth
clubs, youth or community centers, church halls, etc)
- Mobile/outreach VCT services either as solely VCT services or integrated into other mobile services
(particularly for hard-to-reach groups, such as sex workers, drug injectors, or refugees).
Depending on the type of delivery mechanism and the sector providing/supporting the service - government, nongovernmental,
private and community sectors – the cost and content of the service package may vary.
Typically, a classic VCT service package ensures that:
- Knowledge of status is voluntary;
- Pre-test counseling is offered either through one or more sessions with a trained counselor, after which
the client may choose to test on the same or different day;
- Informed consent is obtained from the client by a service provider;
- HIV test is performed using approved HIV test kits and testing protocols (refer to appendix 1 - fact sheet
of the various types of test available);
- Post test counseling (one or more sessions) that includes informing clients of their HIV test results, takes
place on the same or different day.
Testing for HIV without pre- and post-test counseling should not be recommended.
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