Since HIV antibody testing first became available, WHO has advocated for people at risk for HIV to voluntarily seek out HIV testing and counseling. The cornerstone of WHO guidance on HIV testing has remained constant for twenty years: confidentiality, informed consent, and access to counselling. Programmes in many countries offering client-initiated testing and counseling (CITC) – often referred to as voluntary counseling and testing (VCT) – have successfully informed individuals about HIV and prevention measures, and offered HIV test results, counselling and referral for ongoing care and support to millions of individuals.
However, in many high-prevalence countries, fewer than one in ten people with HIV are aware of their HIV status. Reaching individuals with HIV who do not know their serostatus is a global public health priority. The recommendation for universal systematic offer of HIV testing and counseling is seen as an important step to achieving the goal of universal access to care and treatment for all people with HIV. HIV testing also provides an important opportunity for HIV prevention.
Current levels of HIV testing in most countries are low. So in light of steady advances in prevention, treatment and care, WHO and UNAIDS have advocated for an increase in provider- initiated HIV testing and counselling (PITC) in addition to client-initiated testing and counseling (CITC). Following a series of consultations, WHO/UNAIDS jointly released the Guidance on Provider-Initiated Testing and Counselling in Health Facilities (May 2007). This document has guided the development of these training materials and should be seen as an important resource for trainers, policy makers, and others charged with implementing PITC programs.
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