|The Impact of Voluntary Counselling and Testing: A global review of the benefits and challenges (UNAIDS, 2000, 96 p.)|
The Joint United Nations Programme on HIV/AIDS (UNAIDS) is the leading advocate for global action on HIV/AIDS. It brings together seven UN agencies in a common effort to fight the epidemic: the United Nations Childrens Fund (UNICEF), the United Nations Development Programme (UNDP), the United Nations Population Fund (UNFPA), the United Nations International Drug Control Programme (UNDCP), the United Nations Educational, Scientific and Cultural Organization (UNESCO), the World Health Organization (WHO)and the World Bank.
UNAIDS both mobilizes the responses to the epidemic of its seven cosponsoring organizations and supplements these efforts with special initiatives. Its purpose is to lead and assist an expansion of the international response to HIV on all fronts: medical, public health, social, economic, cultural, political and human rights. UNAIDS works with a broad range of partners - governmental and NGO, business, scientific and lay - to share knowledge, skills and best practice across boundaries.
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Many approaches to HIV prevention and care require people to know their HIV status. The importance of voluntary counselling and testing (VCT) in achieving this end has been acknowledged in the recent wider promotion and development of VCT services. VCT has an important role in HIV prevention to help people make changes in their sexual behaviour so as to avoid transmitting HIV to sexual partners if seropositive, and to remain seronegative if negative. The other major role of VCT is in facilitating the early and appropriate uptake of service for those people testing HIV positive and negative, including medical care, family planning, emotional and social support, legal advice and counselling for positive living. VCT is also an essential if women and their families are to benefit from interventions to prevent mother-to-child transmission of HIV. Increasing access to VCT can also be important in challenging stigma, promoting awareness and supporting human rights.
However, since most countries where HIV has a major impact are also the poorest with the fewest resources, VCT is often still not widely available in the highest-prevalence countries. For VCT services to be prioritized and for resources to be provided for their development, demonstrating their effectiveness is essential. Concentrating on information from developing countries, with some examples from industrialized countries, this paper examines VCTs diverse roles, the broad range of outcomes that can be evaluated and the challenges associated with VCT evaluation, particularly the complexity of the VCT process.
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