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

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. 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 PITC: WHAT ARE THE CONCERNS & CHALLENGES? 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. www.aidstar-one.com PITC RESOURCES Go to...