HIV counselling and testing services were started in India in 1997. There are now more than 4000 Counselling and Testing Centres, mainly located in government hospitals. Under NACP-III, Voluntary Counselling and Testing Centres (VCTC) and facilities providing Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) services are remodelled as a hub or ‘Integrated Counselling and Testing Centre’ (ICTC) to provide services to all clients under one roof. An ICTC is a place where a person is counselled and tested for HIV, of his own free will or as advised by a medical provider. The main functions of an ICTC are:
- Conducting HIV diagnostic tests.
- Providing basic information on the modes of HIV transmission, and promoting behavioural change to reduce vulnerability.
- Link people with other HIV prevention, care and treatment services.
Ideally, a health facility should have one integrated counselling and testing centre for all groups of people. However, an ICTC is located in facilities that serve specific categories such as pregnant women. Accordingly, an ICTC is located in the Obstetrics and Gynaecology
Department of a medical college or a district hospital or in a maternity home where the majority of clients who access counselling and testing services are pregnant women. The justification for such a centre is the need for providing medical care to prevent HIV
transmission from infected pregnant women to their infants. Similarly an ICTC is located in a TB microscopy centre or in a TB sanatorium, where the majority of clients are TB patients. As TB is the most common co-infection in people with HIV, availability of HIV counselling
and testing can help patients to diagnose their status for accessing early treatment.
As of today, only 13 percent of HIV positive people in the country are aware of their HIV status. The challenge before NACO is to make all HIV infected people in the country aware of their status so that they adopt a healthy lifestyle; access life-saving care and treatment and help prevent further transmission of HIV. Thus, counselling and testing services are important components of prevention and control of HIV/AIDS in the country.
However, it is not the mandate of an ICTC to counsel and test everyone in the general population. The sub-populations that are more vulnerable or practice high risk behaviour or have higher HIV prevalence levels are the target group for counselling and testing services in the country. In 2006, more than 2.1 million clients accessed counselling and testing services in the ICTC throughout the country. Under NACP-III, the target is to counsel and test 22 million clients annually by the year 2012.
HIV counselling and testing services are a key entry point to prevention of HIV infection and to treatment and care of people who are infected with HIV. When availing counselling and testing services, people can access accurate information about HIV prevention and care and undergo HIV test in a supportive and confidential environment. People who are found HIV negative are supported with information and counselling to reduce risks and remain HIV negative. People who are found HIV positive are provided psycho-social support and linked to treatment and care.