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AIDSTAR-One

This resource examines the implementation of Provider-Initiated Testing and Counseling (PITC) for HIV in PEPFAR countries. It highlights the importance of the "3 Cs"—consent, counseling, and confidentiality—while identifying challenges such as vague policies and lack of training. By reviewing PITC policies and practices across 28 countries, the resource provides insights on improving testing and treatment accessibility. Furthermore, it emphasizes the need for operational guidance and safeguards, ensuring more individuals receive the necessary care and support while maintaining their rights.

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AIDSTAR-One

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  1. AIDSTAR-One Provider-Initiated Testing & Counseling Maria Claudia Escobar HIV Counseling & Testing Advisor BroadReach Healthcare

  2. 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

  3. Prevention Counseling & Testing Care and Support Adult/Pediatric Treatment PMTCT Gender OVC Private sector Quality improvement AIDSTAR-One Technical Areas

  4. 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

  5. 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?

  6. 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

  7. PITC COUNTRY ASSESSMENTS • In-country assessments on PITC IMPLEMENTATION • Informants: • Health care providers • Health facility managers • Clients of health facilities • Generalized and concentrated epidemics

  8. 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

  9. 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

  10. PITC: WHAT ARE THE CONCERNS & CHALLENGES? • 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 OPERATIONAL ISSUES

  11. 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?

  12. PITC RESOURCES Go to... www.aidstar-one.com

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