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

2. 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.
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3. 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
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4. 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
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5. 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.
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6. 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
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7. 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
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8. 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.
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9. 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.
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