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Confidentiality, anonymity, privacy

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Confidentiality, anonymity, privacy
Confidentiality, both as an ethical principle and a legal right, is fundamental for health care. Indeed one of the main worries expressed by people is the lack of confidentiality or name reporting when getting tested. Privacy has to be ensured, ranging from informed consent (sought and given in a private setting) until post-test counselling for HIV-positive clients and other communications relating to HIV status, that must take place away from other clients or staff not involved in the case at hand. There should be nationally approved privacy, confidentiality and security definitions, guiding principles and recommendations for HIV-related data, with relevant capacities for their maintenance. Anonymity, i.e. not requiring names or any other personal identifier is one step beyond confidentiality. Anonymous testing (that is also usually free of charge in UE countries except for Germany) enhances the protection of people’s privacy for communities or settings where there is fear of discrimination and stigma but also when some legal or financial barriers exist, for instance for uninsured undocumented migrants. The criticism that is often raised by institutions about anonymous testing is the difficulty of ensuring linkage to care for those diagnosed with HIV. The quality of pre- and post-test counselling is crucial if we want to avoid some people slipping off the radar.
At that moment, it is very important that the
Pedrana,A.,Guy,R.,Bowring,A.,Hellard,M.&Stoove,M.(2011) Community models of HIV testing for men who have sex with men(MSM): Systematic Review 2011. Report commissioned by ACON

43 person receiving a positive test understands his/her individual benefits, e.g. early diagnosis enables ART (antiretroviral therapy)to be initiated at the most appropriate time, facilitating better health outcomes and therefore longevity. Knowing the efficiency of ART in preventing sexual transmission to one’s partners can also facilitate the acceptance of a positive result and disclosure to one’s partner. When CBVCT centres have developed prompt and durable linkages to ongoing medical care, referring individuals who tested positive to hospital centers is made easier. An anonymous referential can even be given to the person so that he/she will be identified and quickly taken care of at the hospital. Still, CBVCT coordinators report some difficulties in developing and ensuring strong collaborations/partnerships with referral agencies and medical settings. Even if the feasibility and quality of community based testing have been proved, some physicians or other medical actors remain suspicious as if community-based services were less professional

June 2017 2
Theoretical framework regarding the implementation of cbvct .......................... 12
The main objective of this document
How this guide was created.
Definition, objectives and methodology of this guide
How this document should be used.
The objectives of this guide are
The methodology and sources of information used for
European and non-european guidelines
We can state that this document was created from existing experiences in european cbvct centers
A few caveats
Health & sexual health promotion approaches
What is health promotion
Community-based approach – community health
Cbvct in scaling up strategies
Community-based approach
Quality assurance approach
The european quality instrument for health promotion (equihp)
Quality assurance
Figure 1 - dynamics of health promotion projects
Easier access to testing by taking the needs of hard-to-reach populations into
Community based vct can have an impact on three levels:
To foster cbvt accessibility for most-at-risk and hard- to-reach populations,
To be compatible with people’s daily lives, cbvct should
For a positive and comprehensive approach to health and sexual health,
To guarantee sustainability, cbvct services need to
Cbvct implementation among and with populations
Fixed or mobile cbvct programmes should consider
Staff and people involved in cbvct
Items sub-items
Cbvct practices
Before the test
C) after the test
Negative result
Support after positive result
System for conducting assessments of service quality at cbvct centres
Consistency with health promotion principles
Project management
Appendix 1: ten main principles to guide member states as they endeavor to scale up hiv
Appendix 2: self-evaluation tool
How do we encourage participation in the self-assessment?
Preparing the materials
Filling in the self-assessments grids
Our project forms partnerships to help ensure a global response
Scale of the self-
The cbvct project is based on a participative analysis of
The healthcare services that are being offered are adapted
Regarding your practice …
Our organisation / project is developing its ability to
Regarding your practice…

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