Provider Initiated Testing and Counseling Country Policies
AIDSTAR-One is exploring the status of provider-initiated testing and counseling (PITC) implementation in several countries based on the WHO guidelines, Guidance on Provider-Initiated HIV Testing and Counselling in Health Facilities (WHO and UNAIDS 2007). The guidelines emphasize the Three Cs of counseling and testing: consent, counseling, and confidentiality. AIDSTAR-One seeks to better understand how the Three Cs are implemented when PITC is adopted in places with constrained resources and with concentrated and generalized epidemics.
AIDSTAR-One needed to identify countries where PITC was being implemented in order to conduct in-country assessments of PITC. AIDSTAR-One conducted a review of PITC policies in PEPFAR (President’s Emergency Program for AIDS Relief) countries.
How was the review conducted?
An extensive internet search was conducted using various key terms: provider initiated counseling and testing, PITC, VCT, counseling and testing, voluntary counseling and testing, routine HIV testing and HIV policy. Websites of key institutions involved in CT were also searched, including CDC and WHO. Internet searches were conducted by country, and Ministry of Health (MOH) or national AIDS control program websites were accessed to obtain country-specific information about counseling and testing. Information was also gathered from UNAIDS, USAID, and in some cases attempts were made to obtain in-country policy and guideline documents.
For each country, it was determined if a separate PITC policy was available or if it was included in their national CT guidelines. In some cases where an actual PITC policy could not be found, journal articles or MOH websites indicating a PITC policy existed were considered valid sources.
Points to keep in mind
PITC Policy: In almost all cases, countries that have adopted PITC treat it as an extension of overall HIV and AIDS efforts and as an addition to existing CT initiatives. Thus, there are few specific, standalone PITC policies. CT guidelines often cover PITC and often this is implemented through Ministry of Health directives.
Terminology: There is a range of terms used to describe PITC. Routine HIV testing is the most common way to refer to PITC, but even this term can mean different things from country to country (and probably within countries). This review follows the terminology used by individual countries.
PITC Implementation: This review solely considers the existence of PITC policies. Whether PITC is in fact taking place and how PITC it is being implemented in each country is not covered here.
