National CT Policies

1

• National CT Policies Guidelines
• Overview of Key Issues
• Child counselling and testing issues
• Military and disciplined forces
• Re-testing
• Task shifting
• Couples counselling and testing issues,
  especially disclosure
• Post-test support for HIV-negative individuals

2

• Child counselling and testing issues
• Challenges/barriers
• Age of consent
• Age and procedures of disclosure
• Lessons learnt from the workshop
• Diversity in cut-off ages no clear cut age
  distinction
• PITC vs VCT centres
• Next steps/specific action items
• Advocacy
• Harmonisation of legal instruments
• Best interest of the child should be the guiding
  principle
• Skills development and capacity building in child
  counselling and testing

3

• Military and disciplined forces
• Challenges/barriers
• Mandatory testing at pre-recruitment,
  pre-employment, and pre-deployment phases (lack
  of evidence)
• Lack of counselling and other support at
  pre-recruitment
• Lessons learnt from the workshop
• Disconnect between military and public health
  authorities
• Limited involvement of other civil protection
  services (e.g., police) and related
  sub-populations (e.g., prisons)
• Next steps/specific action items
• Need for evidence base for pre-recruitment HIV
  testing
• Need for further discussion between military and
  public health
• Need to engage other civil protection services
  and related sub-populations

4

• Re-testing
• Challenges/barriers
• How often?
• Which settings?
• Which group of people?
• Lessons learnt from the workshop
• PMTCT sero-conversion could occur during
  pregnancy
• May be unnecessary re-testing of HIV-negative
  individuals in some settings (level/type of
  epidemic)
• Next steps/specific action items
• PMTCT Re-test in third trimester or at point of
  delivery
• PITC Re-test annually or earlier if individual
  has exposed himself/herself
• VCT Re-test based on risk assessment

5

• Couples counselling and testing issues,
  especially disclosure
• Challenges/barriers
• Definition of couple
• Disclosure to partner
• Lessons learnt from the workshop
• Institutional policies, with or without legal
  protection for providers
• Background and cultural considerations in
  consequences for disclosure (history of alcohol
  use, violence, etc.)
• Next steps/specific action items
• Balance between public health and social
  instability
• Harmonisation of legal and institutional guidance

6

• Post-test support for HIV-negative individuals
• Challenges/barriers
• Inadequate focus on prevention for HIV-negative
  individuals
• Lessons learnt from the workshop
• Intensity of post-test counselling versus
  pre-test counselling
• Next steps/specific action items
• Provide intensive follow-up counselling for
  high-risk HIV-negative individuals
• Link to prevention services (e.g., male
  circumcision for high-risk males, harm reduction
  for intravenous drug users)