The impact of Voluntary Counselling and Testing A global review of the benefits and challenges

A global review of the benefits and challenges All rights reserved. This document, which is not a formal publication of UNAIDS, may be freely reviewed, quoted , reproduced or translated, in part or in full, provided the source is acknowledged. The document may not be sold or used in conjunction with commercial purposes without prior written approval from UNAIDS (contact: UNAIDS Information Centre). The views expressed in documents by named authors are solely the responsibility of those authors. The designations employed and the presentation of the material in this work do not imply the expression of any opinion whatsoever on the part of UNAIDS concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers and boundaries. The mention of specific companies or of certain manufac-turers' products does not imply that they are endorsed or recommended by UNAIDS in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The UNAIDS responsible staff members were David Miller and Jeanette Olsson. Abbreviations ARV antiretroviral AI anal intercourse DALY disability-adjusted life-year FGD focus group discussion IDU injecting drug users MCH maternal child health MSM men who have sex with men MTCT mother-to-child transmission NEP needle-exchange programme NGO nongovernmental organization OIs opportunistic infections PLHA person living with HIV/AIDS STI sexually transmitted infection SW sex worker TBPT Tuberculosis preventive therapy VCT voluntary counselling and testing UNAIDS UNAIDS 7 B a c k g r o u n d Many approaches to HIV prevention and care require people to know their HIV status. The importance of voluntary counselling and testing (VCT) has brought about the wider promotion and development of VCT services. However, since the majority of countries where HIV has a major impact are also the poorest, the lack of resources has meant that 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 the effectiveness of VCT is essential. One of the difficulties in evaluating VCT's effectiveness is the complexity of the VCT process and the wide range of possible outcomes. The term VCT has also been used in many contexts to cover a broad spectrum of interventions. In this article it includes interventions that comprise a minimum …