Counseling and Testing

Leaders of the University of Belize’s Faculty of Nursing and Allied Health had a vision. Their country has the third highest HIV prevalence in the region, after Haiti and Guyana, yet it lacked an effective system for training providers in counseling and testing. As faculty members, they dreamed of establishing a national training center that would provide the latest resources and trainings for both students and providers. [from author]

This issue of Horizons Report examines HIV testing from different angles, drawing from relevant studies in several countries. These include the readiness of health workers in Kenya to provide routine HIV testing, and the effectiveness of workplace VCT programs in Kenya and Zambia to reach health workers and teachers. [author’s description]

This document evaluates the Support and Treatment for Antiretroviral Therapy project (START) program, a joint initiative of Family Health International (FHI) and the Government of Ghana, to integrate antiretroviral therapy into comprehensive care for people living with HIV/AIDS in Ghana. START helped establish voluntary counseling and testing centers, prevention of mother-to-child transmission activities and clinical care services. Key components of the START program include home-based care (HBC), referral networks and linkages to such existing services as spiritual and social support, and support for orphans and other vulnerable children (OVC).

Providing contraceptive services at VCT centers is an opportunity to prevent unintended pregnancies among clients whose needs may not be met through traditional family planning services. Operations research in Kenya suggests that integrating family planning into VCT services is feasible and acceptable. An integration intervention improved providers’ discussions about fertility desires and contraceptive methods with clients, without compromising the length of client-provider interaction or client waiting time. Although many VCT clients were considered at risk of unintended pregnancy, the i

To maximize program impact with current resources, integration of Family Planning into existing HIV/AIDS programs is a very cost effective and an excellent point of entry. This is a study of an intervention program focused on initiating and also strengthening existing integration of FP into functional VCT, ART and PMTCT sites. The intervention encompassed an orientation on integration benefits to heads of health facilities; identification of challenges of integration and drawing of plan of action on how to overcome the challenges and improve integration. Major challenges identified were related both to health workers, such as high workload, staff burnout and turnover, as well as to efforts in scaling up of facilities operations to adequately incorporate integration activities. [from abstract]

In Mozambique, [Health Alliance International] HAI has been working closely with the MOH for more than fifteen years to support the development and implementation of MOH programs in reproductive health, the response to HIV/AIDS, and malaria control… HAI works with the MOH to implement the nationally designed model of HIV care, and has supported the implementation of voluntary counseling and testing centers, prevention of mother-to-child transmission of HIV (PMTCT) PROGRAMS, and HIV treatment centers integrated into this public sector model of care. [publisher’s description]

This survey is the first attempt to examine the preparedness of the health
system to implement guidelines for HIV testing in clinical settings, and to provide comprehensive AIDS management. This includes availing HIV testing in clinical settings to both adult and pediatric patients, and providing treatment for HIV disease. The survey also examines the working environment in health care facilities, with an emphasis on HIV infection control and access to post-exposure prophylaxis for health workers themselves. [from foreword]

This series provides evaluative case studies of some industry and private sector responses to HIV/AIDS in the past several years. The publications showcase companies that conceived and executed creative and effective programs in the categories of workplace, community, core competency, national action, testing and counseling, and leadership. The winning programs all exemplify best practices and represent the cutting edge of current industry engagement in both established and emerging economies. [adapted from author]

Research conducted by Horizons and partners in Zambia and Kenya shows that health providers and teachers have unmet HIV prevention and care needs, and that they can benefit from workplace programs that include education about and promotion of VCT. [from author]

This report presents estimates of the total cost of providing comprehensive antiretroviral (ARV) treatment in the public sector in Nigeria, using the AIDSTREATCOST model to estimate the cost of providing Highly Active Antiretroviral Therapy (HAART), Voluntary Counseling and Testing (VDT), and Opportunistic Infection (OI) treatment, and other resource requirements for implementing the national antiretroviral (ARV) treatment program

In response to the HIV/AIDS crisis, Namibia’s public health sector is carrying out a comprehensive strategy to rapidly hire and deploy professional and non-professional health workers with the aim of providing comprehensive care, counseling and testing, as well as antiretroviral therapy (ART) and prevention of mother-to-child transmission (PMTCT). [from executive summary]

The goal of this guide is to help the clinic manager or supervisor assure that staff is equipped with the skills and knowledge necessary for providing quality care. This guide offers tips on how to work with your providers, using the Provider’s guide. [from abstract]

HIV counselling and testing is a key component of both HIV care and HIV prevention, but uptake is currently low. We investigated the impact of rapid HIV testing at the workplace on uptake of voluntary counselling and testing (VCT). [author’s description]

Access to voluntary counseling and HIV testing (VCT) remains limited in most parts of Ghana with rural populations being the least served. Services remain facility-based and employ the use of an ever-dwindling number of health workers as counsellors. This study assessed approval for the use of lay counselors to promote community-based voluntary counseling and testing for HIV and the extent of HIV/AIDS-related stigma in the Kassena-Nankana district of rural northern Ghana. [from abstract]

This report presents the findings of a study conducted at 16 healthcare sites in Zambia offering voluntary counseling and testing (VCT), prevention of mother-to-child transmission of HIV (P-MTCT), and antiretroviral (ARV) therapy. The study period, including design, implementation, and data analysis, was April to June 2003. The purpose of the study was to assist the Government of Zambia in determining whether it will have sufficient staff to be able to scale up VCT, P-MTCT, and ARV treatment to reach its targeted numbers of clients. The report analyzes the time taken to carry out the prescribed tasks involved in each of the services, analyzes the extent to which the services are following the national service delivery standards, describes the present workforce involved in providing these services, and analyzes the human resource costs associated with the present workforce arrangements.