Universal Access to HIV Testing
To facilitate knowledge of HIV status and linkage to prevention, care and treatment services.
What the program does
HTC program oversees all issues of HIV testing and counselling nationally. It is responsible for the development of policies, guidelines and job aids required for the implementation of high quality HIV testing and counselling services and coordination of capacity building activities.
Where we are
HIV Testing coverage; HIV testing and counselling has been made accessible to Kenyans up to their doorstep. New strategies have been implemented to improve access to HTC services. These include home based testing, workplace programs, mobile outreaches and annual HTC campaigns. Health facilities now offer HTC as part of routine patient care. Policy documents have been developed to guide HTC implementation at facility and community level
HIV testing and counselling services are a gateway to HIV prevention, care and treatment. The benefits of a person knowing his or her HIV status can be seen at the individual, community and population levels. These benefits include the following:
• Individual – enhanced ability to reduce the risk of acquiring or transmitting HIV access to HIV care, treatment and support; and protection of unborn infants.
• Community – a wider knowledge of HIV status and its links to interventions can lead to a reduction in denial, stigma and discrimination and to collective responsibility and action.
• Population level – knowledge of HIV epidemiological trends can influence the policy environment, normalize HIV/AIDS and reduce stigma and discrimination
Guiding principles for successful HTS
• Adherence to laid down standardized and counselling protocols as part of a public health approach for scaling up testing and counselling services.
• Work towards achieving client-centered HTC services with effective links to treatment, care and support services and responding to other needs of the clients – Post-test support and care services are crucial
• Development of supportive efforts towards improved awareness of the benefits of HIV testing and counselling. This helps to normalize HIV and the corresponding testing and counselling services and to reduce stigma and discrimination.
• Involvement of people living with HIV (PLHIV), communities and other key stakeholders in planning, implementing, monitoring and evaluating HIV testing and counselling services to achieve effective engagement in services being offered.
Approaches towards achieving the HTC mission and 90% HIV testing coverage
1) Enhanced diagnostic HIV testing; this is indicated whenever a person shows signs or symptoms that are consistent with HIV-related disease or AIDS to aid clinical diagnosis and management. This includes HIV testing for all tuberculosis patients as part of their routine management.
1) Provider initiated routine HIV testing; This is initiated by health care providers to all patients especially sexually active youth and adolescents, persons with risky exposure and couples who are offered a comprehensive package of couple counselling and testing,
2) Targeted HIV testing for vulnerable groups
The most significant barriers that deny vulnerable populations access to HIV testing and counselling is stigma and discrimination. These include sex workers, injecting drug users (IDUs), men who have sex with men (MSM), women and children. Partner testing for clients enrolled at the CCCs, their family members including children.
Appropriate and effective HIV testing and counselling services further encompasses linkage to care, follow-up prevention, treatment and support services to achieve a comprehensive HTS package for all those tested.
3) Systems strengthening through;
• Coordination at national and county levels
• Capacity building of TOTs at national level and service providers at county level
• Quality assurance at all levels
• Supportive supervision at all levels
• Provision of guidelines, SOPs and Job aids
• Conducting Annual Rapid Results Initiative for HIV testing and counselling
4) Capacity Building
With the introduction of a new HIV testing algorithm for HTC in Kenya, the need for capacity building is key in ensuring that quality services are offered. To achieve this, the following is the approved levels of training for health workers.
Master Trainers; Participants should be comprised of Medical Lab Technologists, Counsellor Trainers, CASCO and Counsellor Supervisors. Participants to be from all the regions including from a proportion major partner organization. Master trainers are trained by the national team and TWG
TOTs: TOT trainings conducted in all the regions by the master trainers and the national team. The role of the trained TOTs is to rollout trainings in their respective Counties
Service providers: Identified from health facilities within the counties and trained by the trained TOTs with supervision from the national level. Each service provider training of twenty four participants is conducted by four TOTs (two laboratory TOTs and two counsellor TOTs)
5. Quality Control
• External quality assessment
• Rapid testing quality improvement
• RRI – PT panels feedback
6. Tools and Guidelines
• National HTC guidelines
• Service provider job aids and testing protocols
• Couple Counselling curriculum
• Communication strategy
• Community HIV Testing
• National Quality Management Guidelines