TYPES OF COUNSELING AND TESTING

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					                   TYPES OF COUNSELING AND TESTING
Source: CDC Global AIDS Program


Voluntary Counseling and Testing (VCT)

What is VCT?

            Self-initiated HIV testing and prevention counseling
            Often offered in free-standing sites, may be integrated into health centers, mobile units,
            and community-based settings
            Involves extensive pre- and post- test counseling
            Typically utilizes rapid HIV testing

The advantages of VCT are:

            People seeking VCT may be most ready for behavior change; best opportunity for HIV
            prevention
            HIV prevalence among VCT clients usually slightly higher than national prevalence
            Considerations for VCT:
            Most HIV-infected clients in this setting are asymptomatic; VCT not a primary venue for
            accessing ARV eligible persons
            As demand for testing increases with availability of ARVs, VCT alone may not meet
            countries’ needs

Also with the availability of ARVs, VCT sites are required to ensure HIV-infected persons

Couple HIV Counseling and Testing (CHCT)

What is CHCT?

            Intervention in which a counselor provides two people in a sexual relationship with
            information about their HIV status as a couple and assists them in making behavior
            change
            Pre-test counseling focused on HIV risk concerns and preparing for testing
            Post-test counseling for concordant negative couples focused on risk reduction
            Post-test counseling for concordant positive and discordant couples focused on coping
            and support, care and treatment options, family planning and PMTCT, disclosure, and risk
            reduction

Why is CHCT important?

            In countries with high HIV incidence HIV discordance is common
            Both partners must know their HIV status in order to cope with HIV and plan for future
            When partners test separately, they may assume each other’s status, and disclosure
            rates low

The advantages of CHCT are:

            Individual not burdened with disclosing their status or persuading partner to be tested
            Offers safe environment for couples to discuss risk concerns and issues, allows counselor
            to diffuse tension
            Enhances shared understanding of results, as both partners hear the same information
            and messages based on the HIV status of both individuals



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Provider-Initiated Counseling and Testing

What is Provider-Initiated Counseling and Testing?

           Designed to integrate routine offering of HIV CT services into clinical services such as TB,
           STI and family planning clinics as well as out-patient clinics
           Can be an "opt-out" or "opt-in" service
           Opt-in is when each patient must specifically consent to a HIV test, usually in writing
           Opt-out is when each patient is notified that a HIV test is routinely offered and
           recommended, and that he/she may refuse the test (preferred option)
           Intervention is brief- less than a total of 10 minutes of provider time for a HIV negative
           patient and less than 15 minutes for a HIV positive patient.
           HIV negative protocol focuses on partner referral and risk reduction
           HIV positive protocol focuses on clinical care, disclosure partner referral, and providing
           referrals for support

The advantages of Provider-Initiated Counseling and Testing are:

           Increases access to and acceptance of HIV counseling and testing among populations
           who are most likely to be infected and need care
           Facilitates identification of ARV-eligible persons
           Utilizes existing personnel and infrastructure; efficient for clinics to implement
           Facilitates linkages to care and treatment




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