27 October 2007

Zimbabwe: Provider-Initiated HIV/Aids Counselling, Testing Introduced

Harare — IN a bid to effectively respond to the HIV and Aids pandemic, the Government has shifted from voluntary testing to initiated testing where medical service providers can now offer HIV testing to patients.

Head of the Aids and TB Unit in the Ministry of Health and Child Welfare, Dr Owen Mugurungi said provider-initiated counselling and testing is aimed at strengthening HIV service delivery programmes.

"We took that decision because we understood that there were missed opportunities for people to get tested."

Dr Mugurungi said PICT was not mandatory but when people visited a health institution either seeking treatment or other business, health officials at that particular institution can offer HIV testing as part of the hospital services. It is, however, up to the individual to agree to or refuse the testing.

Dr Mugurungi said the move was necessitated by the fact that medical history of people with Aids proved that signs would have begun to show at an early stage when the disease could have been contained.

"It also helps both the service provider and the infected person to plan effectively on either living positively or maintaining a negative status."

He said PICT would preserve the three Cs as defined by the World Health Organisation and UNAIDS namely -- consent, counselling and confidentiality of test results.

PICT was mooted in 2004 and was followed by pilot studies in 2005 but its progress has been slow.

"So far we are on track. The pilot project proved successful and we are getting support from non-governmental organisations," said Dr Mugurungi.

PICT is the advancement to the Opt In-Opt Out concept.

The Opt In-Opt Out concept is being implemented in the Prevention of Mother-to-Child Transmission where all pregnant women are tested for HIV unless they refuse.

Dr Mugurungi also added that expecting mothers were encouraged to bring along their partners for testing.

"We discovered that it would be difficult for women to approach their husbands after they had been tested but if they come together, it lessens the burden and tension in the family."

Dr Mugurungi was, however, optimistic that the shift to PICT and Opt In-Opt Out concept will not lead to mandatory testing citing human rights as the major impediment.

"We will never introduce mandatory testing, instead we are looking forward to mandatory offer of HIV testing for service providers."

The Ministry of Health and Child Welfare emphasised on prevention as a pre-requisite to bringing down the HIV prevalence rate.

The prevalence rate has been declining from a high of 24,6 percent in 2001 to 18,1 percent in 2006, a position which has largely been attributed to behavioural change.

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