India HIV/AIDS Resource Centre
National AIDS Control Organisation
Ministry of Health & Family Welfare, Government of India
Started as Voluntary Counselling and Testing Centres (VCTCs) today basic services under India’s National AIDS Control Programme are offered through Integrated Counselling and Testing Centres (ICTC), a hub which delivers integrated services to all clients under one roof including Prevention of Parent-to-Child Transmission of HIV/AIDS (PPTCT) services. They include testing and test-related counselling to persons who are perceived to be at risk of HIV infection, HIV testing for pregnant women as part of a complete package of ante-natal care and linkage with STI/RTI services and the Revised National Tuberculosis Control Programme (RNTCP).
 
Key Components
 
I. Salient Features:
 
Integrated Counselling and testing Centers
Integrated Counselling and Testing Centres are the entry-point for persons requiring treatment and care services for HIV/AIDS. Such ICTCs are currently established at all district hospitals and medical colleges as well as in priority districts through CHCs. These centres are managed by a qualified counsellor and a qualified laboratory technician. The services include testing for HIV accompanied by counselling.


To ensure that Basic Services are brought even closer to communities that need them, the Department of AIDS Control has been working with the National Rural Health Mission to promote establishment of counselling and testing services through Primary Health Centres using existing health personnel. PHCs where such basic services are offered are called Facility-Integrated Counselling and Testing Centres. 

In addition to walk-in or voluntary clients, ICTC counsellors conduct weekly outreach to Targeted Intervention projects to motivate key populations to visit the ICTC.
 
II. Services:
 
Counselling
The decision whether to test for HIV or not is not taken lightly. Given the level of stigma and discrimination that has historically been associated with AIDS, persons who require testing, require emotional and social support before and after the process. Therefore, every ICTC has a qualified counsellor. Counselling at ICTCs includes key components of confidentiality and informed consent. Persons who test positive for HIV are linked with ART centres for treatment services. Persons who test negative receive guidance on how to remain HIV-uninfected (or to come back for re-testing in case their risk assessment shows such a need). Persons who require additional services may be linked with TB diagnostic facilities and/or STI/RTI services.
 
HIV/TB
One of the most common opportunistic infections in Persons Living with HIV/AIDS is tuberculosis. To emphasize this there is a strong lateral linkage between HIV services and TB services. All persons who are treated under the Revised National Tuberculosis Control Programme (RNTCP) are referred for HIV testing at the ICTC in order to ensure that those who are co-infected may be detected as early as possible and linked with ART centres to receive appropriate treatment. 
 
Further, ICTC personnel are also trained to screen clients who attend the ICTC for symptoms indicative of tuberculosis and to refer them to the Designated Microscopy Centres (DMC) where they may be diagnosed through the appropriate tests. This is called Intensified Case Finding (ICF). Similar activities are also undertaken at the ART Centres.
 
Prevention of Parent to Child Transmission
Transmission of HIV infection from infected mother to the child is responsible for occurrence of HIV in majority of the paediatric HIV cases. This vertical transmission is likely to occur either during pregnancy, labour & delivery or the breast feeding period through the breast milk. If the Anti-Retroviral drugs are provided to infected mother either as life-long ART or as prophylaxis during pregnancy, labour & delivery and breastfeeding period, it can potentially eliminate the vertical transmission of HIV and hence HIV among children. Department of AIDS Control is scaling up the PPTCT services using multi-drug ARV regimens to all the HIV infected pregnant women in the country in a phase-wise manner.

 

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Thematic Area: