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New HIV Counseling and Testing Strategy at PSI

PSI has announced a new counseling and testing (CT) strategy for 2007 – 2009. The new strategy was developed in response to a shift in HIV counseling and testing approaches: public health authorities and policy-makers are increasingly calling for a more comprehensive approach to HIV counseling and testing. Preferred approaches combine the client-initiated VCT model with others that focus on provider-initiated testing and counseling (PITC). Through the new strategy, PSI makes an official statement regarding this paradigm shift, stating that “PSI will develop, support and implement both client-initiated and provider-initiated testing and counseling programs that complement each other by targeting different populations in high HIV prevalence settings.”

While paving the way for future PSI involvement in provider initiated testing, the strategy emphasizes that any routine testing must preserve the 3 C’s as defined by WHO/UNAIDS: informed Consent, Counseling and Confidentiality of test results. Further, while PSI has adopted a new strategic plan, the goals of VCT service delivery and social marketing remain the same: to reduce HIV transmission through high quality counseling and testing –whether client or provider initiated– and to mitigate the impact of HIV through stigma reduction, care and support, and improved access to treatment. The new strategy outlines how PSI will meet these goals. Recommendations include:

• Using multiple services delivery models (for example, clinic-based testing as well as mobile testing) to maximize access
• Creating a demand for VCT and PITC through a variety of communication channels
• Linking VCT clients to treatment, care and support services, especially for rural and underserved populations, and capitalizing on the VCT session as an opportunity for “positive prevention” messages, especially for discordant couples
• Targeting those most in need of VCT (such as couples and high-risk group members) and those least likely to test, which varies by country setting
• Supporting research and disseminating findings on VCT and PITC to support and inform future VCT programs
• Integrate other services and products with VCT, from basic HIV care packages that that include water treatment products and nutritional supplements, to family planning services, TB and STI screening, and other services to prevent opportunistic infections.

The new VCT strategy allows PSI to adapt to shifts in the counseling and testing field, and to continue to improve access to high-quality, confidential counseling and testing services, whether these services are client or provider-initiated, or take place in hospitals, VCT sites, tents or vans. The goal remains to prevent HIV and mitigate its impact around the world.

• PSI's 2007-2009 VCT Strategy