An evaluation of the integration of HIV counseling and testing in other public health care service

Abstract

Over the past 20 years, voluntary counseling and testing programs (VCT) have helped millions of people learn their HIV status, yet more than 80% of people living with HIV in low and middle-income countries do not know that they are infected. HIV testing is a critical entry point to life-sustaining healthcare services for people living with HIV and AIDS and service delivery models need to be expanded to testing in antenatal care, sexually transmitted infection clinics, in-patient wards as well as freestanding client-initiated testing centres. Uptake of counseling and testing remarks low due to stigma, as well as perceptions about poor follow-up and treatment options available for people with HIV/AIDS. In addition, most men do not visit health centres unless they are very sick and as a result, the number of men requesting C&T remains low. This study evaluated the current extent of integration and uptake of HIV counseling and testing in Southern district of the North West province in the different services, and also provides a yardstick for future evaluation of the impact of the proposed interventions. The study was explanatory and quantitative in nature. Data was collected by means of questionnaires, observation and semi-structured interviews. Non-probability sampling was used to select a sample from public health fixed facilities in Southern district of the North West provincial department of health. Findings showed that there is an urgent need to increase VCT services as well as to standardize and expand provider-initiated testing and

counseling so that more people learn about their HIV status. However, endorsement of provider-initiated HIV testing and counseling is not an endorsement of coercive or mandatory HIV testing. It concluded that HIV counseling and testing is not well integrated with other clinical services. Most professional nurses, although trained on VCT, do not provide counseling and rely solely on lay counselors. As a result, HIV counseling and testing is not provided after hours and during weekends, making the service inaccessible.