Community based VCT can have an impact on three levels: Individual: health benefits for each individual Collective:benefits for the community (reduce or stop the spread of the epidemic within one’s community through treatment and positive prevention) Professional, institutional, political & environmental: impacts health systems by adapting itself to the needs of hard-to-reach populations. 3. CBVCT KEY ISSUES
21 In the European countries participating in the COBATEST project, most-at-risk populations are MSM, migrants, transgender people, sex-workers and IDU. Hard-to-reach populations are mainly homeless people, undocumented people, migrants who do not speak the national language, people who do not/cannot benefit from health and social coverage, IDU, MSM and ethnic groups among MSM. As stated before, most of the CBVCT programs participating in the COBATEST project, even if diverse in nature and quantity, and even if they all target “most-at-risk” populations, MSM is still the main targeted population. Community-based staff and a community-based steering committee in CBVCT programs are necessary to create and develop adapted programs for most-at-risk and hard-to-reach populations. Indeed, they know the needs of the community and thus, can adapt the programs to the needs identified by the people at stake. Specific, community-based communication as well as community-friendly organizations are favorable elements to ensure better access to HIV voluntary counselling and testing. A more varied VCT offer increases the likelihood of reaching more and different people.