Voluntary Counselling and Testing (VCT)

We provide and/or advocate for voluntary counselling and testing services that are accessible and confidential.

In many parts of the world severely affected by HIV, as few as one in ten people with HIV know that they are infected. VCT is not only a gateway to treatment, care and support for people living with HIV, but also a critical component of HIV prevention.

Increased access to antiretroviral (ARV) therapy is likely to provide new incentives for people to know about their HIV status. It is estimated that by 2005 there will be up to 180 million people in need of VCT annually. There is an urgent need for VCT services on a much larger scale than has occurred to date, including implementing VCT within different types of health settings in order to maximise entry points to HIV prevention and treatment, care and support.

In establishing or scaling up VCT services, we need to provide and/or advocate for VCT services that:

  • are voluntary, enabling people to give their informed consent to be tested, based on pre-test information about the purpose of testing and the treatment, care and support available once the result is known
  • are confidential, and
  • incorporate post-test support and services that advise those who test HIV-positive on the meaning of their diagnosis, and on referral to the treatment, care and support and prevention programmes and services available to assist them. For those who test negative, post-test counselling or discussions offer an important opportunity to reflect on personal risk reduction strategies or to refer people to prevention programmes.

VCT is an important example of the ways in which public health strategies and human rights protection are mutually reinforcing. VCT protects people's rights by ensuring confidentiality, providing information about HIV transmission and personalising discussions of an individual's risk, thus enabling people to make informed decisions about testing and their own risk. In turn, this builds trust between those at risk and the health system, maximising the effectiveness of prevention programmes and ensuring access to treatment, care and support services where necessary. Mandatory testing, on the other hand, engenders fear and erodes trust and co-operation between the individual being tested and the health system, thus undermining prevention efforts.