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Expanding and Diversifying HIV Testing and Counseling: Findings from the Field

With over 40 million people worldwide live with HIV, of which less than 20% in low- and middle-income countries know their status, HIV testing and counseling is widely regarded as key to effective prevention and treatment efforts. Over the past year, a move toward health provider–initiated testing and counseling (PITC) has gained support among governments and the international health community. However, PITC requires trained health workers, adequate supplies, and clear guidelines that address consent, counseling, and confidentiality. For PITC to yield maximum health impact, it also needs to occur in the context of expanded HIV care and treatment services. Moreover, while PITC has the potential to greatly increase the number of individuals who know their status, it cannot replace voluntary counseling and testing (VCT) and services that reach those who do not access formal health services.

Horizons sponsored a panel discussion which examined the use of different strategies for expanding HIV testing and counseling services in resource-constrained settings. Panelists included PSI, FHI, Horizons/Kenya, Supply Chain Management System, and the Center for Health and Gender Equity. The speakers drew on research findings and program experiences in addressing the challenges and accomplishments of initiating and scaling up both PITC and VCT services.

Dvora Joseph, HIV Service Delivery Manager and Acting Director of AIDSMark, presented about PSI’s innovative country programs, focusing especially on a pilot routine testing and counseling project in Zimbabwe which increased testing by 100% in the target hospital with 50% of outpatients accepted testing. Non-clinical primary counselors relieved the burden of counseling from busy health care workers, and focus group discussions and interviews found that the program was highly acceptable to both health care workers and patients.

For more information on the panel, click here. PSI's presentation can be viewed here.