AIDSTAR-OneProvider-Initiated Testing &

Counseling

Maria Claudia Escobar

HIV Counseling & Testing Advisor

BroadReach Healthcare

AIDSTAR-One

• Global project funded by United States PEPFAR

• PEPFAR: President’s Emergency Program for AIDS Relief

• Implemented by John Snow, Incorporated based in Washington, DC with global presence

AIDSTAR-One Technical Areas

• Prevention • Counseling & Testing• Care and Support• Adult/Pediatric

Treatment• PMTCT

• Gender• OVC• Private sector• Quality improvement

AIDSTAR-One Features Global technical leadership

Knowledge management

On the ground technical assistance

Assessments

Case studies and technical briefs

Program implementation support

Training

Strategic planning

PITC—What do we wish to know?

• How is PITC being implemented with regard to WHO guidelines ?

• Are the 3 Cs of HIV Counseling & Testing being preserved? – consent– counseling– confidentiality

• What are the challenges of rolling out PITC on the ground?

PITC COUNTRY POLICY REVIEW• Examined CT policies of 28 PEPFAR countries

• Majority of countries in Africa

• About half of countries had some form of PITC policy, language in CT policy, or guidelines

• Governments have embraced PITC to bring more people into testing and treatment

PITC COUNTRY ASSESSMENTS

• In-country assessments on PITC IMPLEMENTATION

• Informants: Health care providers Health facility managers Clients of health facilities

Generalized and concentrated epidemics

PITC: WHAT ARE THE CONCERNS & CHALLENGES?

• Policies can be vague• Lack information about legal rights of individuals• Lack regulations and protections for providers • Implementation or guidelines precede policy

POLICY

PITC: WHAT ARE THE CONCERNS & CHALLENGES?

• Operational guidance lacking• Allows for open interpretation of policy • Are HIV tests being recommended or are they being

provided? • When 3 Cs violated, what can be done? Redress?

FROM POLICY TO IMPLEMENTATION

• What are the safeguards for preserving the 3 Cs?• How is quality assured in counseling? Testing? • Human resources---Enough? Overburdened? Trained? • Who can do counseling? Who can do testing? • Is rapid testing happening: Is testing actually rapid—at point

of use? With same day results? • Loss to follow up for results, referral for treatment, care &

support

PITC: WHAT ARE THE CONCERNS & CHALLENGES?

OPERATIONAL ISSUES

PITC: WHAT ARE THE CONCERNS & CHALLENGES?

IMPACT

• Effect of HIV results on client• Stigma and discrimination• Is treatment available? • More people are being tested...but are they getting the

services they need? • Is PITC affordable?

www.aidstar-one.com

PITC RESOURCES

Go to...