Voluntary Counselling And Testing Programme Research Articles

Factors related to the level of prisoner’s participation in implementing the voluntary counseling and testing program in penitentiary Semarang, Indonesia

Introduction: Voluntary Counseling and Testing (VCT) is one of HIV screening programs to detect HIV infection earlier by counseling before and after doing blood test. During implementation of this program, there were various factors influenced prisoners to do VCT. The purpose of this research to determine factors influenced the participation of prisoners to do VCT.Method: This research was an analytical research with cross sectional design. A total of 145 respondents have filled questionnaire distributed by researcher The result showed that 73 respondents (50.3%) have followed VCT and 72 respondents (49.7%) did not VCT yet. Factors related prisoner’s participation (WBP) towards VCT program were education level, perception of needs about VCT service, prison support, health workers support, support by family and people around them.Result: The result showed that there are two types of support related with prisoner’s participation: prison’s support which is among 104 respondents (71.7%) who have high support, 62 respondents (42.8%) have followed VCT with p-value = 0.000. According to health workers support, 114 respondents (78.6%) who have high support, there are 64 respondents (44.1%) have followed VCT with p-value = 0.007.Conclusion: The counselor’s ability must be improved to perform good VCT and the prison was expected to give more information about HIV/AIDS and VCT program to increase prisoner’s knowledge to follow VCT.

Willingness of antenatal care attendees towards voluntary HIV counseling and testing, Southern Ethiopia

Background: Voluntary counseling and testing (VCT) is an entry point for the prevention of HIV transmission from mother to child and accessing VCT benefit from PMTCT services. Even though, some pregnant women clearly know the benefits /advantages of PMTCT services, they are not willing to test and access the services. Hence, this study was aimed to assess the willingness of pregnant women attending antenatal care towards VCT/PMTCT at Adare general hospital in southern Ethiopia. Method: An institution-based cross-sectional study was conducted at Hawassa Adare hospital, southern Ethiopia from February to April/2018. A total of 338 randomly selected pregnant women who were attending antenatal care clinic were included. Data was collected using structured and pretested questionnaire; entered and analyzed using SPSS version 20 computer software. Important descriptive and logistic models were used for data analysis assuming statistical significance at p < 0.05. Result: A total of 338 mothers were interviewed with a response rate of 100%. The willingness towards voluntary HIV counseling and testing among study participants was 82.2%. Participants who attended primary and High school and above were 3.9 (AOR= 3.87, 95% CI- 1.705, 8.782) and 9.5 times (AOR 9.53 at 95% CI- 3.155, 28.76); those who had good knowledge about VCT/PMTCT were 3.47 times (AOR=3.47, 95% CI-1.721, 7.003); women who followed two to three ANC visit, were 5.1 times more likely have willingness towards VCT/PMTCT (AOR 5.11 at 95% CI -1.095, 23.81) more likely willing to be tested than their counterparts respectively. Conclusion: Willingness towards voluntary HIV counseling was encouraging however it needs advancement. Since boosted knowledge and awareness promote willingness to VCT/PMTCT uptakes, initiation of community-based information dissemination, increased quality of ANC service, and empowering women to be educated could be effective in order to promote high VCT and PMTCT program uptakes

HIV Prevalence and Factors Influencing the Uptake of Voluntary HIV Counseling and Testing among Older Clients of Female Sex Workers in Liuzhou and Fuyang Cities, China, 2016-2017: A Cross-Sectional Study.

Objective To compare the prevalence of HIV and associated factors for participating HIV voluntary counseling and testing (VCT) among older clients of female sex workers (CFSWs) in Liuzhou City and Fuyang City in China. Methods A cross-sectional study was conducted and the study employed 978 male CFSWs, aged 50 years and above from October 2016 to December 2017. All participants were required to complete a questionnaire and provide blood samples for HIV testing. Multivariate logistic regression analysis was used to analyze the influential factors of using VCT program and tested for HIV. Results The HIV infection prevalence rate was 1.2% and 0.5%, while 52.3% and 54.6% participants had ever utilized VCT service and tested for HIV in Liuzhou City and Fuyang City, respectively. The older CFSWs who ever heard of VCT program were more likely to uptake VCT program in both cities (ORLiuzhou = 2.224, ORFuyang = 2.421). Participants, whose marital status was married or cohabiting (ORLiuzhou = 0.548, ORFuyang = 0.495), who have stigma against individuals who are living with HIV/AIDS (ORLiuzhou = 0.273, ORFuyang = 0.371), whose monthly income is more than 500 yuan (ORLiuzhou = 0.622, ORFuyang = 0.600), and whose age is more than 60 years old (ORLiuzhou = 0.639, ORFuyang = 0.554), were less likely to visit VCT clinics. Those who are worried about HIV-infected participants were more likely to utilize VCT services in Fuyang City (AOR = 1.838, 95%CI : 1.146‐2.948). Conclusion Combine strategy will be needed to promote the utilization of VCT service, based on the socioeconomic characteristics of older male CFSWs in different cities of China.

Utilization of HIV Voluntary Counseling and Testing (VCT) Services for Pregnant Women in the Working Area of ​​Langsat Health Center Pekanbaru in 2018

For more than 20 years VCT services have been provided, global coverage of PLWHA who use VCT services is still low. UNAIDS reports that 80% of people living with HIV in the world do not know that they are infected with HIV because they have not used VCT services to check their health status related to HIV. VCT is voluntary HIV testing and counseling which is the entry point to help everyone get access to all HIV services. Langsat Health Center is a health center with the percentage of pregnant women utilizing the lowest VCT service, which is 21.6%. The purpose of this study was to determine the factors related to the use of HIV Voluntary Counseling and Testing Services in Pregnant Women in the Work Area of ​​Langsat Pekanbaru Public Health Center in 2018. The research method was quantitative observational analytic with cross sectional studies. Study population numbered 571 pregnant women with a sample of 180 mothers. Data analysis was carried out by univariate, bivariate with chi square test, and multivariate by multiple logistic regression test. Based on the results of multivariate analysis, the variables most related to VCT Service Utilization in pregnant women in the Langsat Health Center Work Area in 2018 are variables of Husband / Family Support (POR: 2,002) and support from Health Workers (POR: 2,571). Conclusion The mother who received husband / family support 2 times using VCT services, the mother who received the support of health workers 2.5 times made use of VCT services. Expected to health workers to increase the socialization of VCT programs, especially to pregnant women who are at risk, husbands / families through mass media, print and electronic and improve screening by conducting VCT for all pregnant women who come to ANC to health facilities

Assessment of Knowledge and Attitudes of Expectant Mothers towards HIV Screening and Counselling at Jachie-Pramso in the Ashanti Region of Ghana

Background: The prevention of mother to child transmission (PMTCT) of human immunodeficiency virus (HIV) is paramount in safeguarding the lives of unborn children and young babies. The study sought to examine the knowledge and attitudes of expectant mothers towards HIV screening and testing in the Jachie-Pramso Community of the Ashanti Region. Methods: The study adopted a descriptive survey approach as its research design. The population of the study comprised 158 expectant mothers who were registered and attended regular antenatal care sessions at the community hospital. The census approach to sampling was adopted for the study. A structured questionnaire was used as the tool for data collection. Chi-square and descriptive statistics were used to analyse the data. Results: The findings from the study indicated that awareness level of HIV and its related issues were high among expectant mothers. It was also found that attitude of healthcare workers, community members and sexual partners are the main factors that prevent expectant mothers from patronising voluntary counselling and testing (VCT) services. It was generally, recommended that intensive educational programmes be instituted to sensitize both healthcare workers and the general public on discriminative behaviours. Conclusion: Most of the expectant mothers have knowledge of HIV and attitudes of the expectant mothers towards VCT of HIV were positive. The healthcare facility and its professionals may consider training the expectant mothers so they can act as snow-ballers in the dissemination of relevant health education and coerce other expectant mothers in the community to participate in the VCT and HIV programmes.

Voluntary Counseling and Testing untuk Orang Berisiko HIV/AIDS

The Study aims to know further about the implementation of Voluntary Counseling and Testing (VCT) to people with the possibility of being infected by HIV/AIDS. It is governmental service program starting from counseling, testing, and post testing in order to minimize the contagious risk of HIV/AIDS. Through the qualitative-descriptive approach, this study showed that the implementation of VCT program is very important because the process emphasizes the acceptance of client, building relationship, exploring, identifying, giving information, planning activity, determining decision, testing, up to developing the readiness of client, making planning, reading off the test’s result, explaining result of the test, giving support and motivation. All of these are purposed to minimize the contagious risk, and make the infected one more optimistic in experiencing life.Keywords: Counseling, Testing, and HIV/AIDS.

Intervention time series analysis of voluntary, counselling and testing on HIV infections in West African sub-region: the case of Ghana

ABSTRACTIn this paper, intervention time series models were developed to examine the effectiveness of the voluntary counselling and testing (VCT) programme in the northern and southern sectors of Ghana. Pre-intervention data of HIV reported cases in the northern and southern sectors were first modelled as Box–Jenkins univariate time series. Second, the adopted models from the pre-intervention data were extended to include the intervention variable. The intervention variable was coded as zero for the pre-intervention period (1 January 1996–31 December 2002) and one for the post-intervention period (1 January 2003–31 December 2007). The models developed were applied to the entire data for the two sectors to estimate the effect of the VCT programme. Our findings indicate that the VCT programme was found to be associated with detection of 20 and 40 new HIV infections per 100,000 persons per month in the northern and southern sectors (p < .10), respectively. The VCT programme in Ghana, like most West African nations, has insignificant impact. Intervention time series models can be used to reliably examine the impact of the VCT programme. The impact of the VCT programme is minimal and we therefore recommend that the National AIDS Control Programme and other stakeholders re-double their efforts to maximise the impact of the programme.

Analysis of Inputs in the Sexually Transmitted Infection Screening with Voluntary Counselling and Testing Program for Female Prisoners at Class II A Jail, in Malang

Background: The increasing incidences of Sexually Transmitted Infection (STI) and Human Immonodeficiency Virus (HIV) infection are becoming serious public health concerns in Indonesia and other countries. These issues are of concern that call for close attention not only for general public but also for male and female prisoners. As studies have shown the prevalences of HIV and syphilis were 1.1% and 5.1% in male prisoners, respectively, 6% and 8.5% in female prisoners. For those reasons, at some jails Voluntary Counseling and Testing (VCT) have been provided for HIV/AIDS control and prevention. The success of the screening program with VCT would depend on the provision of supplies, equipment, infrastructure, health personnel, and fund. This study aimed to analyze the adequacy of various inputs in the STI screening program with VCT for prisoners at the Class II A female jail, in Malang, East Java.Subjects and Method: This was a qualitative study with evaluation approach. This study was conducted at the Class II A female jail, in Malang, East Java. The study applied CIPP (Context, Input, Process, Product) evaluation model. Key informants for this study included health personnels at the Class II A female jail clinics, in Malang, East Java, the STI mobile health care team from Arjuno Community Health Center Malang, and female prisoners, who were known as Warga Binaan Pemasyarakatan (WBP)Results: Average monthly visits at the VCT clinic were 21 female prisoners, which amounted to only a few of the total number of female prisoners. The health care team involved in the STI screening with VCT program, included skilled health personnel from the jail and the mobile STI team from Arjuno Community Health Center, Malang. The sources of fund for these programs came from the International as well as domestic funding agencies. The International funding came from the Global Fund. The domestic funding came from the Ministry of Law and Human Civil Rights, and the Municipality Health Office Malang, which provided reagents and medicine. Supplies, equipments, and infrastructure, were provided by Arjuno Community Health Center Malang and the Class II A female jail clinics, in Malang. The laboratory was provided by the health center. The reagents were sufficiently provided by the municipality health office, although there was a supply delay in February 2016.Conclusion: Inputs of the STI screening with VCT program at the Class II A female jail clinics, in Malang, East Java, which included supplies, equipment, infrastructure, health personnel, and funding, are sufficiently provided. Keywords: analysis, input, screening, STI, VCTCorrespondence: Rosyidah Alfitri. Diploma III School of Midwifery, Dr. Soepraoen Hospital, Malang. Email: elfitri.mafaza@gmail.com.Journal of Epidemiology and Public Health (2016), 1(2): 118-124https://doi.org/10.26911/jepublichealth.2016.01.02.05

Experience of HIV voluntary counseling and testing in antenatal women at a tertiary health centre of North India

Background: Integrating routine HIV counseling and testing as a mandatory part of antenatal care in India has led all pregnant women enter into the prevention of mother to child transmission (PMTCT) of HIV program. Despite such strategies, the effective execution and uptake of these programs remains a major obstacle. It is thus, important to understand the experiences of pregnant women undergoing HIV testing to detect the flaws on the part of the provider and the benefiter and eliminate them to strengthen the PMTCT services. Aim: We studied the acceptability of HIV voluntary counseling and testing (VCT) in antenatal women attending a tertiary health center of the North India. The impact of the sociodemographic factors on HIV prevalence and uptake of PMTCT was also studied, and the possible reasons for dropouts were determined. Methods: Pretest counseling was performed, and sociodemographic data and blood samples were collected from the consenting antenatal pregnant women. Samples were tested for HIV antibodies as per the World Health Organization guidelines. Data were analyzed and presented as mean, percentages, and tables. Results: Of 30,150 pregnant women counseled, 23,464 (77.82%) underwent testing. 136/23,464 women tested seropositive. The prevalence of HIV in antenatal women was found to be 0.58%. The majority of these women were young and belonged to the age group 20–24 years (0.23%). 22% refused testing, the reasons for which were sought. Strong associations were found between the HIV seroreactive status and marital status, low education status, low social class, high parity, and unemployment. Conclusion: To eliminate pediatric transmission of HIV and to create more awareness regarding HIV infection and MTCT, there is a need to make VCT and PMTCT programs more acceptable to the population. The observations found in the study were consistent with the national projections.

Uptake and factors that affect enrolment into the prevention of mother-to-child transmission of human immunodeficiency virus programme in rural Limpopo Province

Background: Before 2006, the uptake into the prevention of mother-to-child transmission (PMTCT) for HIV programme was low in South Africa. We determined PMTCT programme uptake, and identified factors that affected enrolment into the PMTCT programme in the rural Limpopo province. Method: This cross-sectional study, conducted from 21 July to 20 August 2008, involved 200 consecutive women who met the inclusion criteria in the immediate postpartum period. An interviewer-administered questionnaire was used to obtain information on participants’ knowledge and experience of, satisfaction with, and motivation for, enrolling in the PMTCT programme. Main outcome measures included voluntary counselling and testing (VCT) and PMTCT programme uptake rates, and factors reported to influence enrolment into the programme. Results: Of the 200 invited women, 169 (84.5%) responded. The mean age of participants was 25 years ± standard deviation. The human immunodeficiency virus prevalence rate was 23.6%. VCT and PMTCT programme uptakes were 96.9% and 90.9% respectively. Participants reported being aware of (95.2%) and satisfied with (81.6-97.4%) various aspects of the PMTCT programme.The safety of their babies was reported by most participants to be their motivation for enrolment (71.1%). Participants in the age-group 20-29 years were more likely than others to enrol in the PMTCT programme (p-value = 0.01). Conclusion: VCT and PMTCT programme uptakes were high and influenced by good knowledge, satisfaction with the PMTCT programme and participants’ concern for the safety of their babies.

Rapid operation assessment of voluntary HIV counselling and testing services in three cities in China, 2009

ObjectivesTo assess the operation of voluntary counselling and testing (VCT) services for human immunodeficiency virus (HIV) in three cities in China. Study designA cross-sectional study using mixed methods, including focus group discussions, in-depth interviews, field assessment, archive checking and structured questionnaire interviews, was conducted to assess different aspects of VCT services. MethodsSurveys were undertaken in six counties of three China Global Fund AIDS Program (Round Five) cities, including 11 VCT clinics, 38 counsellors, 83 clients and 332 individuals at risk for HIV infection. ResultsAll counsellors were trained and approved for providing counselling. As there were adequate numbers of clinics and counsellors, VCT services ran smoothly. Clients were generally satisfied with VCT services and considered service operation to be adequate. Problems with the VCT programme included fewer VCT services in general hospitals, lack of a referral mechanism, and long delays between testing and receipt of results. ConclusionsThe operation of VCT services in the three cities was generally adequate, but referral services were poor. More attention needs to be paid to HIV testing and counselling in general hospitals, and referral networks need to be strengthened.

The Experiences of HIV-Positive Women Living in an African Village

Kenya has approximately 1.4 million adults infected with HIV/AIDS, with a national prevalence rate of approximately 7.4%. The majority of the Kenyan people have not participated in a Voluntary Counseling and Testing (VCT) program and do not know their HIV status. This increases the likelihood of infecting others and spreading the disease. The Living in fear, making the decision to be tested, the journey toward acceptance, changing behavior, planning for the future, and encouraging others to be tested. VCT programs are crucial in attaining goals related to the prevention and management of AIDS. By exploring these women's experiences and perceptions, issues concerning AIDS and the acceptance and use of VCT may be better understood.

Maximising the potential of voluntary counselling and testing for HIV: sexually transmitted infections and HIV epidemiology in a population testing for HIV and its implications for practice

ObjectivesThis study aimed to describe the epidemiology of HIV infection and sexually transmitted infections (STIs) among persons who attended voluntary counselling and testing (VCT) service for HIV and to assess...

HIV Voluntary Counselling and Testing: Knowledge, Beliefs, Concerns and Practices among Students

The study sought to explore university students' perceptions of the Voluntary Counselling and Testing (VCT) programme. Ninety-nine Black African students were randomly selected from a class of students majoring in psychology to take part in the survey. A questionnaire was used to gather data on the st udents' perceptions of VCT. Data were analysed in terms of response frequencies and percentages. The study showed that most of the participants knew about the VCT programme that was offered by both the government and pr ivate organisations. The students indicated that the VCT programme was important because they were vulnerable to HIV infection. However, most of the students in this study reported that they were not testing for HIV because of leakage of results, fear of knowing their status, stigma tisation and labelling. Participants reported that peer educators, radio and television were their source of information for HIV prevention. Further research with a larger sample is recommended to get generalisable results.

Implementing bathhouse-based voluntary counselling and testing has no adverse effect on bathhouse patronage among men who have sex with men

Implementing HIV voluntary counselling and testing (VCT) in bathhouses is a proven public health strategy for reaching high-risk men who have sex with men (MSM) and efficiently identifying new HIV cases. However, some bathhouse managers are concerned that VCT programmes could adversely affect business. This study examined whether offering VCT on the premises of a bathhouse changed patterns of patron visits. A collaborating bathhouse provided electronic anonymized patron data from their entire population of attendees. VCT was offered on premises with varying frequencies over the course of three years. Club entrances and exits were modelled as a function of intensity of VCT programming. Club entrances did not differ as a function of how many days per week testing was being offered in a given month. Additionally, club entrances did not decrease, nor did club exits increase, during specific half-hour time periods when testing was offered. Implementing bathhouse-based VCT did not have any demonstrable impact on patronage. Public health officials can leverage these results to help alleviate club managers' concerns about patron reactions to providing testing on site, and to support expanding sexual health programmes for MSM in these venues.

An implementation evaluation of a voluntary counselling and testing programme for the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS)

Orientation: Employee wellness programmes have become standard interventions in most organisations. In South Africa, these programmes invariably contain an element to address the problem of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in the workplace.Research purpose: The purpose of this evaluation was to assess whether or not a Voluntary Counselling and Testing (VCT) programme for HIV and AIDS, at a South African university, was implemented as intended.Motivation for the study: The evaluators were motivated to explore indications in the existing literature about these programmes that participants in VCT programmes are often not the intended target population who live a high risk lifestyle.Research design, approach and method: A descriptive design was used to evaluate service utlisation, service delivery and organisational support. Questionnaire data from 285 respondents who participated in the programme and programme records supplied by the programme staff were consulted to answer the evaluation questions.Main findings: The evaluation showed that the highest uptake for the programme occurred amongst female students. The low uptake amongst men was a concern. It was found that the programme was delivered as intended and that there were enough resources to implement it according to standards set.Practical/managerial implications: The systematic report on the programme process provided the programme managers with practical suggestions for programme improvement.Contribution/value-add: This was the first implementation evaluation of a VCT programme in a South African university context. As such it aimed to educate programme managers to think evaluatively about introducing new or continuing existing programmes.

Voluntary Counselling and HIV Testing in Schools of the Mbashe District, Eastern Cape in Rural South Africa: retrospective analysis

South Africa has the highest number of HIV infected individuals worldwide. Local Voluntary Counselling and Testing (VCT) is one component of the national strategic plan to tackle this. The Mbashe district lies in the heart of the Eastern Cape, a low resource rural community with poor infrastructure and access to health care facilities. In addition to these physical obstacles, HIV stigma is a significant barrier to attendance at clinic-based VCT. Outreach is therefore a vital component of VCT and HIV education programmes.

Utilization of HIV Voluntary Counseling and Testing in Vietnam: An Evaluation of 5 Years of Routine Program Data for National Response

This study evaluated the utilization of HIV voluntary counseling-and-testing (VCT) services targeting high-risk populations in Vietnam in order to inform decisions on program improvement and expansion. A total of 158,888 records collected from 55 VCT sites supported by the U.S. Centers for Disease Control and Prevention's Global AIDS Program in the period of 2002 to 2007 were used to analyze sociodemographic characteristics, risk exposures, seropositivity, test refusal, and failure to return for test results among VCT clients. High-risk exposures, such as injection drug use, commercial sex work, homosexual contacts or heterosexual contacts with high-risk sex partners, were reported in 126,815 (81%) records. Among high-risk clients, any condom use in the past month ranged from 34% to 71%. During the study period, 19% of the VCT encounters resulted in a positive HIV test; of those persons tested, 23% of men and 13% of women were HIV-positive. High HIV positivity rates were associated with injection drug use, being ill/recommended by health care provider, and having an HIV-infected sex partner. Of all records, 6.1% documented refusal of HIV testing. Failure to return for results was reported in 3.5% of records for clients who were tested. Previously testing positive was the strongest predictor of test refusal, and being referred by peer educators was associated with failure to return for results. The VCT program in Vietnam successfully targeted high-risk populations, and clients had high return rates using a standard testing strategy. Interventions to increase consistent condom use and promote access to prevention services among sex partners of high-risk individuals should be implemented and evaluated.

Global income-related inequalities in HIV testing

Voluntary counseling and testing (VCT) is an important prevention initiative in reducing HIV/AIDS transmission. Despite current global prevention efforts, many low- and middle-income countries continue reporting low VCT levels. Little is known about the association of within- and between-country socioeconomic inequalities and VCT. Based on the 'inverse equity hypothesis,' this study examines the degree to which low socioeconomic groups in developing countries are disadvantaged in VCT. Using recently released data from the 2002 to 2003 World Health Survey (WHS) for 106 705 individuals in 49 countries, this study used multilevel logistic regression to examine the association of individual- and national-level factors with VCT, and whether national economic development moderated the association between individual income and VCT. Individual income was based on country-specific income quintiles. National economic development was based on national gross domestic product per capita (GDP/c). Effect modification was evaluated with the likelihood ratio test (G(2)). Individuals eligible for the VCT question of the WHS were adults between the ages of 18-49 years; women who had given birth in the last 2 years were excluded from this question. VCT was more likely among higher income quintiles and in countries with higher GDP/c. GDP/c moderated the association between individual income and VCT whereby relative income differences in VCT were greater in countries with lower GDP/c (G(2)= 9.21; P= 0.002). Individual socio-demographic characteristics were also associated with the likelihood of a person having VCT. Relative socioeconomic inequalities in VCT coverage appear to decline when higher SES groups reach a certain level of coverage. These findings suggest that changes to international VCT programs may be necessary to moderate the relative VCT differences between high- and low-income individuals in lower GDP/c nations.

Provider-initiated testing and counselling for HIV - from debate to implementation

Recent statements by the new Minister of Health about ‘mass voluntary counselling and Testing (VCT) campaigns’, and references in the latest draft VCT policy to ‘provider-initiated VCT’, suggest that a policy space is opening up in South Africa for the expansion of HIV testing models beyond the current VCT approach. The existing VCT programme is showing some successes. For example, the Human Sciences Research Council (HSRC) has reported a dramatic increase in the number of 15 - 48-year-olds who report awareness of their HIV status, from 11.9 % in 2005 to 24.7% in 2008. Despite increased testing rates and willingness to test, most HIV-positive people do not know their status, do not consider themselves at risk and do not self-initiate testing, even with widespread awareness of and accessibility to VCT services. Barriers associated with VCT uptake include clients having to initiate testing themselves, lengthy pre- and post-test counselling, implementation barriers (organisational management, supervision, human resource and infrastructure limitations), and patient concerns about confidentiality. Possible strategies for expanding HIV testing include ‘provider-initiated HIV testing and counselling’ (PITC)6 – also referred to as ‘opt-out’ HIV testing or ‘routine offer of HIV testing’ – and broad-based testing approaches such as ‘mass VCT’ campaigns, mobile VCT services, community- and home-based HIV testing initiatives and self-testing.