VCTC in India

[Guest guest]

Hello all,

The posting of Dr. Bitra on VCTC in India is

well thought out and quite exhaustive. This definitely

calls for some mid course corrections in the process

of voluntary testing and Counselling. I would take

this opportunity to highlight a couple of issues.

However, some homework needs to be done before we

start talking about ideal and model VCTCs.

I would like to believe, that there is no such

concept of a model center. Situations change over

periods of time. It is being widely seen in African

settings, where HIV prevalence remains high, that the

concept of VCTC as thought a couple of years earlier

has undergone changes. Stand alone VCTCs has not been

found to be sustainable unless it is linked to Care

programs. Therefore, in high prevalent areas it is

very necessary to establish such a referral network

in the beginning, while establishing VCTCs. In India,

it would appear cost beneficial if such centers are

located in hospital settings where it is easier to

establish linkages. One must also not forget, that

medical services has historically been fraternal. The

question is does this hold good in present day

settings?

The next point of concern is appointment of

counselors. In areas of low workload, it would again

appear logical to utilize the existing staff in the

Microbiology depts. Until trained counselors are

available or there is a genuine need. I need to

emphasise here that functioning of a VCTC need not be

a water-tight compartment. It should be as flexible

as possible. However, there must not be compromise on

quality of counseling services. This brings us to the

question of training. The institutions mentioned by

Dr. Bitra like TISS, NIMHANS do offer quality training

definitely handle such a task if correctly addressed

and in a systematic fashion.

As mentioned by counseling experts, the telephoning

counseling and email/internet based counseling are

basically dissemination of information and strictly

speaking not counseling. One needs to study ground

reality as to where such concepts fit in the scheme of

things of the counseling process. Number of people

accessing information through telephone or email is

not a reflection of good counseling. Rather it

reflects the need to good counseling services.

One would like to hope the earth from the ideal

VCTC, but one must not forget that the VCTC would be

fulfilling its most important function if it can

provide an entry point to care services.

S. N. Misra

E-mail: <misranaco@...>

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