National Guidelines for HIV Counseling and Testing
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Transcript National Guidelines for HIV Counseling and Testing
National Guidelines for HIV
Counseling and Testing in Clinical
Settings:
PROVIDER INITIATED COUNSELING AND
TESTING
THATO FARIRAI
BIRCHWOOD HOTEL
AUGUST 10,2010
What is PICT? Why PICT?
HIV counseling and testing initiated and recommended by
health care providers (HCP) to persons attending health
care facilities as a standard component of medical
care
Voluntary service, patients may decline the test without
being denied medical services
HCPs are best suited to provide patient centered care to
empower their patients
Providers to make clinical decisions or medical services
based on the knowledge of the patient HIV status
Approach to scaling up HCT
PICT Objective
To assist HCP to expand quality HCT services in
clinical settings to reduce the impact of HIV among
individuals, families and communities by reducing
HIV transmission.
Intended users of the guidelines
HCP involved in the clinical care and management of
patients
Providers in both public and private facilities
Need for supportive health system
Trained personnel
Logistics supply at community and facility level
Who Should be offered Testing?
All patients attending health facility as part of medical
care;
Measures for rational use of resources by prioritizing:
Pregnant women
Patients with TB symptoms and those diagnosed with TB
STI patients
Patients for SRH including FP&TOP
Male patients presenting for SRH
All inpatients
MMC patients
Patients requiring non-occupational PEP
Patients reporting history of IDU
Sexual partners and children of HIV positive patients
PICT Principles
Informed consent
Confidentiality
Counseling
As prescribed by the HCT policy
PICT Process
Health Education
Pre-test counseling
Informed consent
Post test counseling
Health Education
Can be provided to patients as a group or individuals
Provide information about HIV
Promote PICT
Prepare patients for the CT process
All patients should be offered the test and those who
accept must receive pre-test counseling
Person responsible: the facility manager is responsible
for implementing and overseeing the QA procedures
Pre Test Counseling
Provided to individuals not to groups
Provider to be guided by the patient’s needs
If lengthy counseling is anticipated then patient is referred to
the lay-counselor
It should cover the following:
Evaluating the patient’s understanding of HIV information
Reinforce messages
Explain the testing process
Provide an opportunity for patient to ask questions
Obtain consent
Person responsible: HCP
Informed Consent
HCPs do not have a right to test patient’s without
informed consent
PICT requires verbal consent for HIV testing
documented in the patient records
Person responsible: HCP
Post- Test Counseling
Content to be informed by the results of the test
Results to be given to individuals not group except in
the case of couples
Minimum content for HIV negative
Minimum content for HIV positive
Person responsible: HCP
PICT Protocol
Recommended testing algorithm
PICT protocol for out patient settings
PICT protocol for inpatient settings
Other issues covered
Confidentiality
Disclosure of results ( patient and HCP)
Referrals and linkages
Issuing of written results
Frequency of testing
Special Considerations
PICT for children
Obtaining consent and assent
Abandoned babies
Disclosure in children
Appropriate HIV tests for children
PICT in ANC
Couple counseling
PICT in TB services
PICT in SRH
PICT in MMC
Integration on PICT in MMC
Incapacitated patients
Testing in the context of sexual offences
Special Considerations
Patient flow
Caring of carers
Occupational exposure
Infection control
Stigma and prevention
Quality assurance
Social mobilization
Monitoring and evaluation
Supervision
ART
THANK YOU