Preventing HIV Infection

Voluntary Counselling and Testing (VCT) for HIV Prevention

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Why is VCT Important for HIV Prevention?

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.

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: -

  1. Free-standing sites: facilities set up solely to provide VCT services

  2. 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)

  3. VCT services provided within already established non-health locations and facilities (like youth clubs, youth or community centers, church halls, etc)

  4. 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:

  1. Knowledge of status is voluntary;

  2. 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;

  3. Informed consent is obtained from the client by a service provider;

  4. 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);

  5. 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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