Provider Initiated HIV Counseling and Testing Unit 5: Overview of PIHCT Protocol Structure

Objectives Describe the way the PIHCT protocol is organized Discuss the purpose of each section of the PIHCT protocol. Describe the benefits of the HIV Rapid test and the testing process. Review the infection prevention steps required while performing testing. 5-1

Provider-Initiated HIV Counseling and Testing Protocol May Be Delivered in Group Setting or by Provider Notify Patient of Routine HIV Testing, Ensure Understanding and Benefits of Testing (1) Patient Declines or Defers Testing (3-A) Recommend and Offer HIV Test: Determine HIV Test History and Answer Questions (2) Problem Solve Barriers to Testing Rapid Test Performed (3-B) Develop Plan to Return for HIV Test Inform Test Result is Negative (4) Inform Test Result is Positive and Provide Support (6) Provide HIV Clinical Care Recommendations (7) Address Partner Referral and Motivate Patient to Reduce Risk (5) Address Disclosure and Partner Referral (8) Address Risk Issues and Provide Referrals (9) May Be Delivered by Provider or Counselor 5-2

Initial Provider Encounter Provider informs patient of the importance of HIV testing: - Many persons with TB or other illnesses related to HIV, also have HIV - Diagnosis of HIV is important for medical care Provider informs patient of routine testing policy: - clinic’s policy to test all patients for HIV - test will be performed unless patient objects Provider determines HIV test history and answers any questions 5-3

Benefits of the HIV Rapid Tests Rapid tests require a blood sample, which can be collected by a finger-stick. They can be processed on site without laboratory equipment. They take less than 30 minutes to develop. Some take only 15 minutes. Clients can receive their result the same day as the testing procedure. 5-4

HIV Rapid Testing Algorithm or “Testing Line-Up” Determine Capillus* Uni-Gold Contains: A peel –off strip Separate buffer solution Separate pipette or micro-filter tube Capillary slide Separate latex reagent Separate pipettes and tips Plastic strip Use this test as a: Screening test Confirmatory test Tie- Breaker test * Since Capillus test kit require refrigeration, Oraquick test kit can be used in setting where refrigerator is not available 5-5

How to Interpret the Client’s HIV Test Result Serial HIV test HIV Screening Test HIV Confirmation Test Client’s HIV Result Negative - Negative Positive Positive Positive Positive Negative Result of the tie-breaker test 5-6

For Patients Who Test Negative Provider informs patient of negative test results Recommends repeat testing in 12 weeks. Gives patient brief message about prevention Advises patient that partner needs to be tested. 5-7

For Patients Who Test Positive Provider informs patient of positive test result Supports patient in adjusting to results Informs patient of need for HIV care and treatment Gives patient information about HIV prevention Advises patient of need to get partner tested. 5-8