HIV/AIDS Program Spotlight
HIV counseling and testing: A crucial strategy in preventing the spread of HIV/AIDS
A major challenge to reaching the targets set by the President’s Emergency Plan for
AIDS Relief (PEPFAR) is that the majority of individuals are unaware of their HIV status, impeding
both behavior change efforts and timely access to appropriate care and treatment services. Because
it serves as the gateway to all other HIV interventions, counseling and testing (CT) for HIV is
a crucial strategy in preventing the spread of HIV/AIDS and is directly linked to achieving PEPFAR
targets for the number of people receiving care and treatment. Individuals who test negative for
HIV can be counseled on how to remain disease-free, and for individuals who test positive, CT
provides an opportunity to help them:
- plan for the future;
- access care and treatment, including antiretroviral therapy
and management of HIV-related illnesses and opportunistic infections;
- prevent transmission to others, including mother-to-child
transmission; and
- access services for people living with HIV/AIDS.
Jhpiego works closely with the
U.S. Agency for International Development,
U.S.
Centers for Disease Control and Prevention (CDC), ministries of health, national AIDS programs,
nongovernmental organizations and faith-based and community-based organizations to create
sustainable training and health care delivery systems for the provision of high-quality CT
services. For example:
Jhpiego has provided technical assistance to the CDC in Ethiopia,
conducting four courses to train 88 counselors of walk-in CT clients at hospitals and providing
trainee follow-up to ensure transfer of learning. Jhpiego also trained 42 providers in
provider-initiated CT, in which clinicians who provide health care services for patients with
tuberculosis and sexually transmitted infections (STIs) are trained to provide testing and
counseling to their patients rather than referring them to CT services. To date,
provider-initiated CT has been effective not only in increasing client numbers for CT, but
also in identifying much higher rates of positive clients (21% of clients tested positive
at regular services while 44% tested positive at provider-initiated CT).
During the period
between April 1, 2005, and January 31, 2006, approximately 74,000 clients were counseled
and tested at Jhpiego-supported sites in Ethiopia. Jhpiego has also developed training materials
to train a cadre of lay counselors in Ethiopia, and will begin training and deploying lay
counselors on a pilot basis in the next few months. These training materials are currently
being translated into local languages.
Working with the Government of Kenya, Jhpiego has developed
a strategy to integrate family planning with CT. Jhpiego’s Kenya office developed a 2-day,
group-based orientation package for training CT providers in family planning counseling and
service provision. The Ministry of Health has officially endorsed the package, which is now
being used throughout the country to promote integration of family planning and CT services.
Jhpiego is also working with the Ministry of Health in Kenya to train
health care providers in diagnostic testing and counseling (DTC) in clinical settings.
With PEPFAR funding, Jhpiego/Kenya worked with the National AIDS and STI Control Programme
to conduct DTC trainings for 450 health workers from 32 health facilities in Nairobi, Central
and Eastern provinces. The cascade approach was used to build local capacity to provide
DTC—the 450 health workers directly oriented an additional 2,250 health workers to DTC,
leading to increased uptake of HIV testing and antiretroviral therapy and decreased stigma
among health workers in the community.
In the Caribbean, Jhpiego has worked to expand HIV
CT services to more than 300 public sector, nongovernmental and non-traditional service delivery
sites, such as prisons, in more than eight countries. Our focus is on training trainers and
counselors, developing and implementing performance standards for CT, and improving the quality
of CT services. Almost 2,000 people have been trained in CT since the program began.
Innovative approaches increase use of CT services in many of our programs.
Jhpiego reached more than 4,000 at-risk youth in Ghana by providing CT
services that targeted them after the harvest season when they moved from the countryside to Accra.
With support from the CDC, in Zambia we are implementing an alternative to stand-alone CT
services that is designed specifically for patients with tuberculosis and can be used in
any type of health care facility. Jhpiego’s work in ensuring provision of high-quality and
innovative CT services is an important contribution to the ultimate goal of creating a
new social norm for all adults in high-prevalence countries to know their HIV status.
More Information
To read other spotlights, go to Program Spotlights.
For additional resources on HIV/AIDS, browse our
Information Sheets and/or
go to the HIV/AIDS section of our Publications Catalog.
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