From caution to urgency: the evolution of HIV testing and counselling in Africa.

Baggaley, R; Hensen, B; Ajose, O; Grabbe, KL; Wong, VJ; Schilsky, A; Lo, YR; Lule, F; Granich, R; Hargreaves, J; (2012) From caution to urgency: the evolution of HIV testing and counselling in Africa. Bulletin of the World Health Organization, 90 (9). 652-658B. ISSN 0042-9686 DOI:

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To describe recent changes in policy on provider-initiated testing and counselling (PITC) for human immunodeficiency virus (HIV) infection in African countries and to investigate patients' experiences of and views about PITC. A review of the published literature and of national HIV testing policies, strategic frameworks, plans and other relevant documents was carried out. Of the African countries reviewed, 42 (79.2%) had adopted a PITC policy. Of the 42, all recommended PITC for the prevention of mother-to-child HIV transmission, 66.7% recommended it for tuberculosis clinics and patients, and 45.2% for sexually transmitted infection clinics. Moreover, 43.6% adopted PITC in 2005 or 2006. The literature search identified 11 studies on patients' experiences of and views about PITC in clinical settings in Africa. The clear majority regarded PITC as acceptable. However, women in antenatal clinics were not always aware that they had the right to decline an HIV test. Policy and practice on HIV testing and counselling in Africa has shifted from a cautious approach that emphasizes confidentiality to greater acceptance of the routine offer of HIV testing. The introduction of PITC in clinical settings has contributed to increased HIV testing in several of these settings. Most patients regard PITC as acceptable. However, other approaches are needed to reach people who do not consult health-care services.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Centre for Evaluation
Population Studies Group
PubMed ID: 22984309
Web of Science ID: 308972900007


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