Preventing HIV Infection

Voluntary Counselling and Testing (VCT) for HIV Prevention

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What Can UNFPA Do?

Advocating for and supporting the provision of counseling and testing services for HIV is a relatively new area for UNFPA.

However, within the context of our response to the HIV/AIDS pandemic through preventing HIV infections – the Fund is well placed to integrate quality VCT services in the programmes and activities it supports.

UNFPA’s overall aim should be to ensure those at highest risk of HIV infection have access to affordable and acceptable VCT services, and that VCT becomes an integral component of programmes addressing HIV prevention among young people, pregnant women and their sexual partners.

In addition, the following aspects may be considered:

Support the development of innovative ways to provide VCT services to vulnerable sub-groups of populations ( pregnant women, potential users of condoms, injecting drug users, victims of rape and sexual abuse, street youth, etc.) – when focusing on such sub-groups it is important not to increase marginalisation, stigma and discrimination. Quality counselling should be driving force in supporting VCT interventions.

Critically analyse models of good practice for VCT services and support the scaling up, expansion and/or replication of such successful models.

Actions specific to UNFPA’s core areas:

1. VCT for Young People

Work with appropriate sector ministries, including health, education, youth and sports, and youth and youth-serving organizations to include promotion of VCT benefits for young people within existing life and livelihood skills training and other educational curricula and to enhance and or revise protocols and guidelines to incorporate VCT services within sexual and reproductive health services for young people. VCT should be promoted as part of an essential package of information and services that should be available for sexually active young people in- and out-ofschool. Combining VCT with a range of other youth-focused activities has many advantages in attracting youth rather than freestanding services.

Ensure that programmes for young people which incorporate VCT also provide or refer/link to programmes that can provide psychosocial and emotional support through ongoing HIV/AIDS information and education, HIV-related counseling and post test HIV/AIDS clubs for young people.

2. VCT and Condom Programming

VCT sites are a valuable venue for condom promotion and distribution. Such sites should routinely have sufficient supplies of male and female condoms to meet ongoing client needs.

The pre- and post-test counseling sessions provide the opportunity for ongoing support for effective condom use. VCT services need to explore the merits of condom social marketing and free distribution according to their client groups to promote demand for VCT services.

To maximize their effectiveness for condom programming, they should advertise themselves as condom distribution points irrespective of HIV testing.

3. VCT for Pregnant Women

Both to prevent infection in pregnant women and to reduce transmission to children, VCT needs to be integrated early into antenatal care services. UNFPA’s core focus should be helping pregnant women to stay HIV negative or to prevent further infection by promoting the benefits of knowing ones status and of safer sex practices including the use of condoms throughout pregnancy and lactation. Appropriate mechanisms to enable HIV positive women to access antiretroviral treatment to protect their infants should be established in collaboration with other partners.

Promote couple counseling for VCT, and male involvement in all aspects of SRH so that men take increasing responsibility for sexual and reproductive health and understand the need for dual protection or, during pregnancy, for STI/HIV infection prevention.

Other General Actions for UNFPA’s Support:

Policy and Programmatic Development:- Using its distinct relationship with governments and sector ministries, UNFPA has an urgent and vital role to play in facilitating, through continued advocacy and technical assistance, the development and/or realignment of policies, and national strategic plans and programmatic guidelines including testing protocols, that provide a supportive environment for the incorporation and delivery of quality VCT services in RH settings. These include policies and programmatic issues related to amongst others discrimination and stigma, disclosure and openness about status, age of informed consent and mandatory testing.

Capacity Building:- Support for capacity building of service providers working in antenatal and maternity care, with youth as part of youth friendly health services, in family planning and STI management settings, to deliver quality VCT through clarifying providers values around HIV/ AIDS and testing for HIV, and improving their behavioural change information, communication and counseling skills.

BCC/IEC:- Continue to contribute to the development and dissemination of appropriate behaviour change information and communication messages and materials around VCT and HIV/ AIDS.

Provision of Rapid HIV Test Kits:- As part of commodity management, ensure support to government to effectively coordinate the procurement, logistics and distribution of HIV rapid test kits and other HIV preventive commodities including male and female condoms through strengthening commodity management and logistic management systems at all functional levels.

Operations Research:- Contribute in collaboration with others, to operational research on VCT good practice regarding, for instance, quality of service, feasibility, accessibility, acceptability, sustainability, cost effectiveness, cost benefit, integration into different settings and scaling up.

Partnerships:- Establish effective partnerships with other UN cosponsors, NGOs, particularly women and youth serving NGOs, governments, community organizations, the private sector and individuals living positively with AIDS, so as to ensure a continuum of care. In particular, collaborate with UNICEF and WHO regarding VCT provision for young people and pregnant women and their partners.

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