Abstract #298  -  Provider-initiated routine offer of HIV testing: lessons learned
Authors:   Presenting Author:   Prof Sheila Tlou - University of Botswana
Additional Authors:  Dr Khumo Seipone,
Aim: Botswana was the first country to introduce Provider Initiated Routine Offer of HIV Testing in 2004. The aim of this presentation is to share successes and challenges of this intervention based on reported client experiences as well as the results of national programmes on prevention, treatment, care and support most of which cannot be accessed without HIV testing.
Method / Issue: When routine HIV testing was introduced, it was very controversial issue with potential human rights violations. After five years of implementation and community dialogue, it is now accepted as one of the HIV interventions and is expected by clients as they use the health care system.
Results / Comments: Botswana has achieved major milestones within four years of implementing Provider Initiated Routine Offer of HIV Testing.Knowledge of one's HIV status increased from 10% to over 50%; Access to ARV treatment increased from 20% in 2004 to over 95% in 2008, and mother to child transmission of HIV was reduced from 40% in 2004 to 2% in 2008. Acceptance of HIV testing by Batswana has been such that there has been a reduction in stigma and discrimination, with most clients and health personnel reporting overall satisfaction with the intervention. Major challenges include gender issues and pockets of discrimination in the absence of legal protection.
Discussion: Major accomplishments can be achieved in the areas of HIV prevention, treatment, care and support using Routine HIV testing. However, the intervention raises some human rights issues that have to be dealt with, especially in settings where there are few legal recourses against stigma and discrimination. Based on experiences and lessons learned, especially from the Botswana situation, the World Health Organisation has guidelines on Routine HIV Testing within a human rights framework.Botswana gave to the world the concept of Provider-Initiated Routine Offer of HIV testing.
Go Back