Basic Service Division (BSD)

What is Integrated and Counselling Testing Centre

• An integrated counseling and testing center is a place where a person is counseled and tested for HIV, on his own free will or as advised by medical provider and convinced that the test is mandatory
• He / She is assured that the process will be confidential
• The main functions of an ICTC include:
  • Early detection of HIV
  • Provision of basic information on modes of transmission and prevention of HIV/AIDS for promoting behavioural change and reducing vulnerability
  • Link positive people with other HIV prevention, care and treatment services
  • Follow up counselling
  • Prevention of Parent to Child Transmission (PPTCT)
  • Cross referrals – TB/STI/ART/TI-NGO/DIC/CCC etc

ABOUT ICTCs – Vatsayan Kendra & Mamta Clinic (VK&MC)

• • Vatsayan Kendra & Mamta Clinic (ICTC) provides people access to knowledge of their HIV status and is a key entry point to prevention of HIV infection and to care for infected people.
  • It helps in reducing the risk behavior and promotes safe sex along modification of behavior.
  • ICTC supports people to understand the implications of their sero-status.
  • Learn about prevention of HIV infection for self, child or others.
  • Learn to cope with the psychological and social impact of HIV, and make more informed choices for future.

HIV Counseling and Testing Services in India and Gujarat

• • More than 8000 ICTC Centers in India
  • Approximate more than 2500 ICTC/FICTC Centers in Gujarat
  • The Challenge before us is to make all HIV Infected People in the Country and Gujarat aware of their status so that they adopt healthy life styles and prevent the transmission of HIV to others, and access life – saving care and treatment.
  • Counseling and testing services are an important component of prevention and control of HIV/AIDS in country and Gujarat

ELEMENTS OF HIV COUNSELLING

• • A confidential dialogue
  • An evaluation of personal risk of HIV transmission facilitation of preventive behavior.”
  • To help them make a decision about whether or not to be tested,
  • To provide support and facilitated decision-making following testing.

Who needs to be tested in an ICTC

• • It is not the mandate of an ICTC to Counsel and test everyone in the general population
  • There are Subpopulation who are more vulnerable or practice high risk behavior.
  • These sub – populations include sex workers and their clients, Men who have   sex with men (MSM), transgender, injecting drug users (IDUs), Truckers, Migrant workers, spouses and children of man who are prone to risky behavior.
  • HIV prevalence levels are typically higher among these sub populations than in the general populations
  • Medical Providers also refer patients who have a history of risky behavior or have signs and symptoms suggestive of   HIV/AIDS for Counseling and testing to an ICTC.  

Where can an ICTC be located

• • ICTCs should ideally be located such that they provide maximum access to at-risk/vulnerable populations.
  • It is important to ensure that facilities for counseling and testing be located as close to the people as possible.
  • Under the National AIDS Control Programme, Phase II, Integrated (Voluntary) and Confidential Counselling and Testing Centres have been established at district level Government hospitals and Medical Colleges across India.
  • Under NACP phase III: strengthening the existing VK&MC(ICTC) and expanding services sub district level and in private sector.
  • So as to make it’s functional……
  • In public interest
  • Easily accessible,
  • User friendly and
  • Generate demand for wider usage

Salient features

In Gujarat ICTC/FICTC are functional across the state:

• Vatsayan Kendra (covering general clients) and
• Mamta Clinic (covering ANC clients),
• Facilitated ICTC (FICTC) where government interior health facility
• Public Private Partnership (PPP) mode FICTC
• • All testing should precede pre test counseling and followed post test counseling.
  • Testing to be done by three different tests.

Purpose of HIV Testing

• • Information is useful for prophylaxis, medical management and treatment of HIV and related
  • To assure blood safety and donation safety
  • To assess the efficacy of targeted intervention in a defined cohort.
  • To monitor trends of epidemic (sentinel surveillance etc.)
  • Identification of asymptomatic individuals (practicing high risk behavior)
  • To plan personal and family’s future if the result is positive.
  • To motivate for behavior modification through counseling amongst those who test negative and who practice high risk behaviors.
  • To induce behavior change and prevent transmission by counseling in those who are test positive
  • To diagnose clinically suspected cases
  • For peace of mind of individuals practicing high risk behavior

General Principals of HIV Testing

• • It should be part of the overall comprehensive and preventive programme
  • Testing should be technically sound and appropriate.
  • Test Procedure must be cost effective.
  • Laboratory Procedure must be monitored for ensuring quality.

Most important points for HIV Testing

• Inform Consent after pre test counseling for HIV testing
• Confidentiality

Input Under NACP

• • Counselor
  • Laboratory Technician
  • Infrastructure development Fund- Onetime Cost
  • HIV Kits
  • Grants for Consumables, furniture & Contingency

Expectation from Centre

• • Overall in charge : Superintendent/MD
  • ICTC - in charge : Superintendent/Medical Officer
  • Monitoring
  • Guidance/Supervision as per NACO guidelines
  • Stock & Data Maintenance
  • Regular Reporting
  • Space: separate rooms with waiting space.