Comparative benefits of traditional tests versus rapid tests Items Sub-items Conventionnal Tests Rapid Tests Populations’ needs Invasive technique ( e.g. DU) +++ + Trust in reliability of the test +++ + Receipt of results ++ +++ Accessibility Affordability of testing process + ++ Time to obtain result + +++ Anonymity + + Walk-in vs appointment + +++ Additional tests (same blood sample) Confirmatory test +++ Plus hepatitis tests +++ Plus other STI tests +++ Efficiency Early detection seroconversion period (6 weeks vs 3 months) +++ + Sensitivity ++ ++ Specificity ++ ++ Ease of use + + Location Inside the center clinics ++ + Outreach settings Community venues + +++ Mobile testing ( vans & other facilities) + ++ Staff Medical staff +++ + Community counsellors & testing staff volunteers +++ Peer educators trained to do test ++ Administrative and logistic organisation Storage + +++ Transportation + +++ Reduced traceability steps + ++ Post-test support Immediate post-test Counselling versus counselling several days later + +++ Positive prevention for Pb+ +++ Quick linkage with formal health settings ++ ++
36 3.5 The use of counselling in CBVCT Counselling in CBVCT is one of many tools used in a global process. HIV counselling means that we receive information, support and referral through a dialogue with a trained counselor before and after the HIV test. In CBVCT we consider that the counselling, is a great opportunity for the clients to increase their health management skills. We speak of pretest and post-test counselling as two different opportunities to discuss multiple issues such as informed consent during the pretest counselling and referral during the post-test. But in fact, it is important to look on these conversations as a whole and to consider the importance of providing these conversations by only one counselor. Thus, counselling can be adapted to each client, even giving him/her the choice to only talk about some issues or to skip others, in particular when it comes to those who get tested frequently. Counselling during the HIV testing process can be conducted indifferent ways directive or semi directive interviews, the Rodgers approach, motivational interviews, etc. Numerous guidelines and checklists have already been produced on HIV counselling. These documents list important approaches and attitudes to be developed in order to conduct the counselling in the best possible way.