Scaling up VCT benefits and service delivery

HIV prevention and care are inextricably linked components of the stepped up war against AIDS disease and a Voluntary Counseling and testing (VCT) serves as a unique bridge between the two. Although VCT is an important entry point for HIV prevention and care, not all population groups have an equal likelihood of accepting VCT and therefore public health interventions on HIV testing is specifically tailored for each population group. In addition to its role in prevention, HIV testing and counseling is a critical first step in identifying those who are HIV positive so as to effectively link them with HIV treatment, care, and support services. These services include the prevention of HIV-related illnesses, (including tuberculosis), psychosocial and family support, and comprehensive treatment with anti-retroviral therapy, as it becomes available. Knowing one’s HIV status also provides essential information to better enable HIV positive persons to plan for their own future and that of their family. VCT can help to connect clients with services including hospital care, legal services, and support for orphans and vulnerable children. Experience has shown that VCT clients benefit from ongoing support and counseling to cope with their diagnosis and facilitate disclosure.

Voluntary testing for HIV/AIDS disease is an important exercise as it enables one to know his or her own health status.

Studies carried out in Tanzania, Kenya and Zimbabwe have shown that while around 60 percent of adults want to know their HIV status, only 15 percent or less have had access to VCT. Carefully designed radio, television, and print advertising have not yet increased awareness and use of VCT services in most parts of these countries. Most VCT clients report positive experiences with disclosure of their HIV status, yet HIV positive women may remain more vulnerable to negative effects. Studies have shown that fear of a violent reaction by a male partner because of a positive result is a barrier to both VCT and subsequent disclosure of results to male partners. HIV-related stigma and discrimination contribute to the creation of a barrier to participation in VCT, disclosure of HIV status, and seeking care, treatment and support by people living with HIV/AIDS. Involving the community in VCT and related programs helps to increase participation in VCT and fosters community ownership of the programs. This approach can help people living with HIV/AIDS to be accepted within their communities, thereby reducing stigma and denial. Providing VCT with quality counseling and appropriate linkages, referrals, and prevention and care services can enhance the opportunities for people living with HIV/AIDS to access care, treatment and support. A key component of infection control is the identification of those infected with the disease, coupled with efforts to interrupt transmission. Studies in the developing world have demonstrated that VCT can lead to self-reported changes in high-risk sexual behavior among both HIV positive and HIV negative people. In U.S based studies, participant reports of sexual behavior change have been further corroborated by a reduction in sexually transmitted infections. The body of evidence is especially strong for VCT as a tool to help HIV positive persons to reduce their high-risk behaviors to avoid spreading the disease to uninfected persons. VCT counselors work one-on-one with clients to help them to assess their individual risk for HIV and engage them in a focused discussion of realistic ways to reduce their risk.

A person is being tested for HIV/AIDS at Angaza centre

Voluntary counseling prepares individual both psychologically and physically to understand and accept the results from an HIV testing exercise and this directly influences the accessibility of the available care orphans. Rapid testing for HIV has become one of the most prominent ways that people receive HIV tests today. In as little as 20 minutes, you can find out your HIV status. Rapid tests work similarly to traditional HIV test, they look for antibodies to HIV, not the virus itself. Most commonly, a rapid test is administered by sampling the oral mucosa (the mucous that is everywhere in your mouth) and putting it through a test to see if HIV antibodies are present. The provision of integrated VCT services in several districts in the country are using the rapid HIV testing technique almost at every HIV testing centers. The overall aim is to ensure that confidential VCT is widely accessible by clients with a number of generally improved health services delivery. Since the introduction of the program, there has been rapid uptake of services reflecting that demand is very high. Analysts to the trends in the socio-demographic factors of the VCT clients facilitate understanding of those who volunteer to be tested to pave way to the development of appropriate interventions to further control the AIDS epidemics. HIV antibody testing can be ordered through a private physician, some clinics, and hospitals. If you give your name, even if the test site says your name is known only to them and not the lab, the test is technically confidential and anonymous. Confidential antibody testing means that you and the health care provider know your results, which may be recorded in your medical file. There are also testing sites that offer confidential testing. “Those who are tested confidentially and are found to be infected with HIV are reported to local public health officials so that the government can better track the extent of the disease in the population as a whole”, says doctor Francis Michael of Manyoni district hospital. According to him, the information is collected to allow public health officials to track these diseases. HIV reporting makes it easier for localities to collect information about the epidemic, providing the government with valid, uniform data for service and prevention planning.