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AIDSTAR-One

AIDSTAR-One. Provider-Initiated Testing & Counseling. Maria Claudia Escobar HIV Counseling & Testing Advisor BroadReach Healthcare. AIDSTAR-One. Global project funded by United States PEPFAR PEPFAR: President’s Emergency Program for AIDS Relief

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AIDSTAR-One

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  1. AIDSTAR-One Provider-Initiated Testing & Counseling Maria Claudia Escobar HIV Counseling & Testing Advisor BroadReach Healthcare

  2. AIDSTAR-One • Global project funded by United States PEPFAR • PEPFAR: President’s Emergency Program for AIDS Relief • Implemented by John Snow, Incorporated based in Washington, DC with global presence

  3. Prevention Counseling & Testing Care and Support Adult/Pediatric Treatment PMTCT Gender OVC Private sector Quality improvement AIDSTAR-One Technical Areas

  4. AIDSTAR-One Features • Global technical leadership • Knowledge management • On the ground technical assistance • Assessments • Case studies and technical briefs • Program implementation support • Training • Strategic planning

  5. PITC—What do we wish to know? • How is PITC being implemented with regard to WHO guidelines ? • Are the 3 Cs of HIV Counseling & Testing being preserved? • consent • counseling • confidentiality • What are the challenges of rolling out PITC on the ground?

  6. PITC COUNTRY POLICY REVIEW • Examined CT policies of 28 PEPFAR countries • Majority of countries in Africa • About half of countries had some form of PITC policy, language in CT policy, or guidelines • Governments have embraced PITC to bring more people into testing and treatment

  7. PITC COUNTRY ASSESSMENTS • In-country assessments on PITC IMPLEMENTATION • Informants: • Health care providers • Health facility managers • Clients of health facilities • Generalized and concentrated epidemics

  8. PITC: WHAT ARE THE CONCERNS & CHALLENGES? • Policies can be vague • Lack information about legal rights of individuals • Lack regulations and protections for providers • Implementation or guidelines precede policy POLICY

  9. PITC: WHAT ARE THE CONCERNS & CHALLENGES? • Operational guidance lacking • Allows for open interpretation of policy • Are HIV tests being recommended or are they being provided? • When 3 Cs violated, what can be done? Redress? FROM POLICY TO IMPLEMENTATION

  10. PITC: WHAT ARE THE CONCERNS & CHALLENGES? • What are the safeguards for preserving the 3 Cs? • How is quality assured in counseling? Testing? • Human resources---Enough? Overburdened? Trained? • Who can do counseling? Who can do testing? • Is rapid testing happening: Is testing actually rapid—at point of use? With same day results? • Loss to follow up for results, referral for treatment, care & support OPERATIONAL ISSUES

  11. PITC: WHAT ARE THE CONCERNS & CHALLENGES? IMPACT • Effect of HIV results on client • Stigma and discrimination • Is treatment available? • More people are being tested...but are they getting the services they need? • Is PITC affordable?

  12. PITC RESOURCES Go to... www.aidstar-one.com

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