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Voluntary Counselling and Testing

Voluntary Counselling and Testing. Lessons Learned from ProTest Pilot Sites and Recommendations. VCT Objectives of Pilot Projects. To increase access to voluntary counselling and HIV testing Promote VCT as an entry-point to care Evaluate effectiveness. Achievements. Lessons Learned.

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Voluntary Counselling and Testing

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  1. Voluntary Counselling and Testing Lessons Learned from ProTest Pilot Sites and Recommendations

  2. VCT Objectives of Pilot Projects • To increase access to voluntary counselling and HIV testing • Promote VCT as an entry-point to care • Evaluate effectiveness

  3. Achievements

  4. Lessons Learned • Population coverage good in a short period of time and with modest additional resources; much lower in rural sites where no additional resources allocated • In resource poor settings it is possible to implement VCT services utilising existing staff and on-site rapid tests • Unmet demand exists: • different service models well utilised and attract different clientelle • Increasing proportion of self-referred clients • Impact of rapids: • Contribute to increased uptake in services • More clients get results – Malawi – 70-80% - >99% • Logistics – interrupted supply results in fluctuations

  5. Lessons Learned • Both nursing staff (Bohlabela) and “lay” counsellors are able to provide quality counselling services (CT) • Increasing human resources (counsellors) increases access to VCT • Providing a package of care results in nurses being more enthusiastic about promoting VCT • Simple reporting and recording systems help evaluate programme

  6. Recommendations • VCT should be established in a range of different settings to ensure broad access (clinical settings including TB hospitals/PHC clinics, stand-alone VCT centres) • On-site rapid HIV testing should be used: • Standard National / WHO Protocols for testing • Quality assurance mechanisms need to be in place • Secure logistics established • Review of National policies on who does tests required for scale-up

  7. Recommendations • Invest in human resource • Use of lay personnel or dedicated staff required for scale-up (Govt/NGO) • Mentorship / supervision • Develop standard reporting and recording tool for testing across programmes • Quality assurance for counselling is useful (UNAIDS tools) and should be done

  8. Outstanding Information • Completion of cost analyses across sites to allow some comparison of costs of different models • Measure impact of VCT on behaviour change and model impact on HIV and TB • Cost-effectiveness based on measures of epidemiological impact • Future: Impact of VCT on stigma?

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