Re Response to VCT programmes in India: A Kerala experience

[Guest guest]

Dear Friends,

The posting of Dr. Bitra on VCT program for

discussion is very timely that NACP-II target - " One voluntary testing

center has to be established in each district in the country " - is being

implemented.

Issues faced by our center - who provides counselors for VCT programme

in Thiruvananthapuram district of Kerala are mainly around implementing the

guidelines set by NACO, especially the following points:

*VCTC counselors may be provided by the NGO's and will work under the

administrative control of the officer in charge of the testing Laboratory.

* Counselors need adequate training and on-going support and supervision to

ensure that they give good quality counseling and avoid burnout.

* Innovative ways of scaling up VCTC services and making them more

accessible and available should be explored.

* The choice of VCTC service will depend on the needs of the community, HIV

sero-prevelence.

* As part of the follow up counseling, the VCTC services should offer the

opportunity of on-going care and support for seropositive case and should

act as entry point to medical care. Collaboration and cross referral care

ensure that people with HIV receive appropriate medical care, including home

care and supportive palliative care.

* VCTC services should therefore be flexible and either be able to provide

ongoing counseling or have close links with other organizations for referral

like community organizations, spiritual groups or with health facilities.

* Referral system should be developed in consultation with NGO, community

based organizations, hospital. The location and opening hours of the service

should reflect the needs of the community.

Being confronted with the problems of care and support of HIV/AIDS

patients, we as an NGO are finding it extremely difficult to arrive at a

common understanding regarding the above guidelines with Kerala State AIDS

Control Society, the sponsoring agency. Thereby forfeiting the efforts of

NGOs to establish a networking of referral systems and making the VCT

services accessible to more people. Another area of concern is the awareness

level and attitude of medical/health care professionals to HIV/AIDS

patients, even in the tertiary hospital settings.

Given this scenario, our dilemma is about the effective strategies to be

implemented at various levels to reduce the stigma and fear attached to this

disease. We are also aware of the protocol set by Freedom Foundation Trust

( www.thefreefoundation.org <http://www.thefreefoundation.org/> )

With regards from,

Dr. Vadakekara

Coordinator

THRANI center for crisis control <http://www.geocities.com/thrani>

Red Cross Road, Thriuvananthapuram

Kerala, India - 695 037

eMail: thrani@...

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