Martiliska, Candida & Gonneke HIV[e]Education SXM. December 2009

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1 Provider Initiated Testing and Counseling Martiliska, Candida & Gonneke HIV[e]Education SXM December 2009

2 Testing to be major focus of AIDS awareness campaign ~ Act Red, Go Test, theme for 2010 ~ PHILIPSBURG--Large scale testing campaigns will be a predominant feature in next year s HIV/AIDS public awareness campaign, launched on World AIDS Day, Tuesday. Themed Act Red, Go Test, the campaign is the third part of the Programme Management Team (PMT) RED drive geared towards creating awareness about the pandemic. The World AIDS Day activities also included a march organised by NAGICO

3 Scaling-up HIV Testing Provider Initiated Testing and Counseling What to do? (casus)

4 Scaling up Testing and Counseling Benefits of testing - Early access, early care - Possibility to benefit from care - Prevent further transmission - Make family planning choices - Possibility to make lifestyle changes - Planning for possible health problems - Fight stigma, discrimination

5 History HIV Right to know HIV status AIDS Open up Epidemic PITC + VCT cart / /7 HIV epidemic Voluntary Counseling Testing AIDS reporting

6 Provider Initiated Testing & Counseling Awareness of HIV status is low 38% of Americans do not know their HIV status¹ 1/4 of HIV infected persons was not aware of HIV status² Unable to benefit from care Unable to reduce forward transmission CDC: New guidelines for HIV testing 2006³ opt out method WHO: Guidance on provider-initiated HIV testing and counselling in health facilities ª 1. CDC. MMWR 2004;53: Glynn M. et all. Naional HIV Prevention Conference a.

7 Voluntary Counseling Testing Client - initiated & Provider Initiated Testing Counseling Provider - initiated

8 opportunity

9 Why do we need PITC?

10 Scaling up Testing and Counseling Barriers for HIV testing - Fear of abandonment - Fear of violence - Loss of job - Loss of family support - Community rejection - Fear of illness and mortality - Denial of past HIV risk behavior

11 PROTOCOL FOR PROVIDER-INITIATED HIV TESTING AND COUNSELING Group Health Education Explanation of HIV/AIDS Review prevention measures Test may be offered Provider Initiates HIV Intervention test recommended Confidentiality assured Consent obtained using opt-out language For Patients Who Opt Out Counsel on testing benefits Identify barriers to testing Provide emotional support Re-assess intention to test Specimen Collected Specimen for HIV test collected by appropriate person [5-30 minute wait for results] Second Test Performed if Indicated- per national protocol If initial test is positive, second sample obtained and new test performed. HIV Test Results Given HIV test results are delivered and interpreted Post-Test Advice and Provider offers Referral information about referrals, and if positive, refers to treatment and care and advises on importance of disclosure. PAHO 2009

12 3 C s PITC Consent Opt-out Confidentiality Access to Counseling

13 Opting out The HIV test would be carried out unless the patient declines. ( opts out ) HIV tests should be offered routinely People must be fully informed before testing and receive counseling afterwards No test should be done against a person's wishes or without their knowledge

14 What should the doctor know?!

15 Health Education Address your patients chief complaint first Start education by asking what your patient already knows Use simple words Patients retain 3 take home messages

16 What should a person who gets tested know?!!?

17 Health Education Mechanics and logistics of testing and receiving results Facts about transmission and prevention Possible repeat testing Information about treatment and services Importance of disclosure

18 Case Martiliska Busby & Candida Mc Crae

19 Testing to be major focus of AIDS awareness campaign ~ Act Red, Go Test, theme for 2010 ~ PHILIPSBURG--Large scale testing campaigns will be a predominant feature in next year s HIV/AIDS public awareness campaign, launched on World AIDS Day, Tuesday. Themed Act Red, Go Test, the campaign is the third part of the Programme Management Team (PMT) RED drive geared towards creating awareness about the pandemic. The World AIDS Day activities also included a march organised by NAGICO

20

21 Laboratory Diagnostics ELISA Western Blot PCR Viral Load CD4 T-cell Count

22 Screening Primary HIV Infection Viral load (7-10 days) HIV screening (EIA), after 3 months

23 Screening HIV

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