Provider-initiated testing and counselling for HIV - from debate to implementation
Despite increased testing rates and willingness to test, most HIV-positive people do not know their status, do not consider themselves at risk and do not self-initiate testing, even with widespread awareness of and accessibility to VCT services. Barriers associated with VCT uptake include clients having to initiate testing themselves, lengthy pre- and post-test counselling, implementation barriers (organisational management, supervision, human resource and infrastructure limitations), and patient concerns about confidentiality.
Possible strategies for expanding HIV testing include ‘provider-initiated HIV testing and counselling’ (PITC)6 – also referred to as ‘opt-out’ HIV testing or ‘routine offer of HIV testing’ – and broad-based testing approaches such as ‘mass VCT’ campaigns, mobile VCT services, community- and home-based HIV testing initiatives and self-testing.
Natalie Helene Leon, MRC
Christopher J Colvin,
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Date published: 2010-03-30
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