1. P1 Process and Flow of Client at ICTC

2. P2 The clients accessing ICTC may be: Individuals with high risk profession (immigrant workers, truck drivers, CSW etc.) Pregnant women Individuals with STIs Adolescents and young adults staying away from home and practicing high risk behavior Multiply transfused cases Symptomatic cases not responding to the usual treatments IVD users Rape cases Partners and family members of HIV positive persons

3. P3 Process Flow for HIV Testing 1.Client accessing ICTC services 2.Register client 3.Pretest counseling 4.Informed consent where provider initiated testing is not offered 5.Collect blood sample 6.Perform HIV testing 7.Read and interpret the final result 8.Inform the client with post test counseling 9.Maintain confidentiality 10.Refer HIV positive clients to the designated ART site for assessment of clinical and immune status by clinical work-up and CD4 cell count. 11.Follow up counseling

4. P4 Client Flow Pre-test counseling. Informed Consent (where provider initiated testing is not offered Collect Blood Samples Perform HIV Testing Read & Interpret Final Result Client accessing ICTC

5. P5 Client Flow Cont. Inform Client with post Test Counseling HIV Negative HIV Positive Continuum of Counseling for Behavior Change Refer to ART for Clinical & Immunological Work- up and Pre-ART care. Maintain Confidentiality Follow-up Counseling

6. P6 Pre-test Counseling Give knowledge about disease Do not judge, do not criticize Explain the test, the fallacies i.e. false positive and false negative Emphasize need for possible retesting Give hope, create positive feeling by explaining about ART Empower the individuals to accept the result by creating hope and positive feeling Explain the safe behaviors and motivate for behavior change

7. P7 PPTCT ANC clinic-Group counseling of pregnant women. Inform in addition about the drug intervention through PPTCT. Counsel about breast feeding Offer HIV testing Collection of blood and HIV testing HIV positive woman-explain the possibility of HIV positive baby, describe the options (abortion, PPTCT, breast feeding options, etc.) to enable to make informed decision.