Voluntary Counselling and Testing

Over 90 percent of an estimated 42 million people around the world living with HIV/AIDS reside in Africa, Asia, Latin America and the Caribbean where the resources are limited for prevention, detection and treatment. It is estimated that less than 10 percent are aware of their infected status because of the limited accessibility and availability of Voluntary Counselling and Testing. VCT is therefore a confidential, honest and inexpensive method to help people receive information, counselling and testing to determine their HIV status.

What is Voluntary Counselling and Testing (VCT)?

  • VCT stands for Voluntary Counselling and Testing. It is a process that is undertaken when a person wants to find out if they are infected with HIV. Because it is voluntary, a person who thinks they might have HIV decides on their own whether they want to have the test done. If the individual decides to go ahead with the testing, they will have the opportunity to discuss the test with a trained counsellor. Most clinics use a rapid accurate scientific test that makes the results available, usually within twenty minutes after the test has been performed.i
  • Voluntary Counselling and Testing (VCT) for HIV is an efficient internationally recognized approach for people to find out their HIV status at VCT centers. It has become one of the most effective and popular ways of diagnosing people who may have been exposed to the virus or who have been infected.
  • VCT is an important tool for preventing the spread of HIV—especially in communities where the epidemic is widespread. It allows for adolescents to find out their own HIV status in order to evaluate their behaviour and its consequences.ii
  • VCT clinics usually have 45 minute counselling sessions that provide information about HIV and AIDS and the testing process. VCT provides a confidential and non-judgmental environment for people who want to know their HIV status.
  • VCT can help to improve advocacy and reduce stigma by giving people the opportunity to talk anonymously and confidentially with counsellors about their HIV status.

Who should be tested for HIV/AIDS?

Everyone should be aware of their HIV status and therefore it is crucial that everyone be tested in a world were HIV/AIDS is so prevalent.

The Testing Process:

After the body has been exposed to HIV, it begins to develop antibodies. Therefore the tests that are used to determine whether a person is infected with HIV detect the presence of antibodies in the blood. Since it takes between 21 to 90 days for the body to begin to develop antibodies there is a 3 month period necessary between the time of transmission and testing that must pass before the test can be done accurately.iii

There are Three Main Steps in VCT:

  • First, there is a session of pre-test counselling where questions about HIV/AIDS and the test are discussed and answered by a counsellor. The counsellor will help the individual determine whether testing is appropriate given the information that is shared with them about the reasons the individual wanted to be tested. Sharing information about their past sexual behaviour will help the counsellor determine whether testing is appropriate. After making their assessment, if the counsellor deems it appropriate for the person to take the test they should iv:
  • Describe the test and how it is performed
  • Explain AIDS and the way HIV infection is spread
  • Discuss ways to prevent the spread of HIV
  • Explain the confidentiality of the test results
  • Discuss the meaning of the possible test result
  • Ask what impact you think the results of the test will have on you
  • Discuss whom you might tell your results to
  • Discuss the importance of telling your sex and/or drug-using partner(s) if the results come back positive
  • Second, when the person decides to have the HIV test they must sign a consent form before the test can be administered. Informed consent is a crucial part of the VCT process and it is important that the individual is aware of their right to refuse any medical procedure, to be informed about it, and to agree to it. There is a statement which they should be asked to read beforehand stating that they have been informed about the HIV-antibody testing procedure, that they understand, and have given their consent to have the test performed.v
  • Finally, after the test has been done the counsellor gives the results to the person in the post-test counselling session (it usually takes around fifteen to twenty minutes after the test has been administered for the results to come backvi). If they are found to be HIV-positive (meaning that they have HIV) then they are referred to medical specialists and other counsellors in order to aid them in receiving treatment and support.

How is the HIV test performed?

In order to determine a persons HIV status a blood test has to be administered. VCT centers most often use rapid tests that require either a small amount of blood from the individual’s arm or cells from the inside of a person’s cheeks, the sample of which is then taken to a lab and tested. The benefit to undergoing VCT is that the tests are cheap and they require little training to be administered. The results are accurate and the individual can find out their HIV status within fifteen to twenty minutes after the test has been taken.

Strategies for Promoting VCT to Young People

  • Some of the strategies that have been used to effectively promote VCT to youth include communication messages (i.e. television advertisements, campaigns, newspaper and magazine ads etc.) that are designed with a target audience in mind. This strategy is particularly important in countries where the HIV epidemic is localized or exists within geographically hard to reach populations.vii
  • Fear tactics must not be used since they tend to perpetuate discrimination and stigma. VCT advertisements that relay messages of hope, incorporating notions of the future, healthy positive attitudes and safety tend to be much better received within the targeted audience.viii

Some barriers to VCT for young peopleix

  • Some of the barriers to VCT for young people include limited availability, legal issues and accessibility of VCT services.
  • Waiting times and costs
  • Pressure by health staff to notify partners
  • Worries about confidentiality and fear that the results of HIV tests would be shared with partner(s) and/or parent(s) without their consent.
  • Fear of being stigmatized and labelled by their friends, families and communities.
  • Inadequate prevention, care and support from health care providers (i.e. councillors, doctors, nurses etc.) to effectively meet the needs of youth.

What is Antiretroviral Treatment?

Antiretroviral drugs are the main treatment for HIV/AIDS. Though the treatment is not a cure, it can stop people from becoming ill for many years. The treatment consists of several drugs that must be taken every day for the rest of a person’s life once they find out that they are HIV positive.

How do Antiretroviral Drugs Work?

  • Antiretroviral (ARV) drugs work to slow down the replication of HIV in the body. By undergoing antiretroviral treatment the drugs help to control the amount of HIV in the body; it restores and protects the immune system’s functioning by allowing the CD4 cells (white blood cells) to replenish themselves; it also helps to reduce HIV related illnesses and to prolong and improve the quality of life for people living with AIDS in the long run.x
  • In order for ARV treatment to be effective, a person who has HIV must take several ARV’s at the same time. This is called combination therapy.
References: 
i http://www.aidshelpline.org.za/vct.htm
ii http://www.unicef.org/lifeskills/index_8017.html
iii http://www.uottawa.ca/sante/hiv/hiv/stages.html
iv http://www.thebody.com/content/art17037.html#11
v http://www.thebody.com/content/art17037.html#11
vi http://www.aidshelpline.org.za/vct.htm.
vii http://www.usaid.gov/our_work/global_health/aids/TechAreas/docs/vctyouth.pdf
viii http://www.usaid.gov/our_work/global_health/aids/TechAreas/docs/vctyouth.pdf
ix http://www.usaid.gov/our_work/global_health/aids/TechAreas/docs/vctyouth.pdf
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