Guest guest Posted June 29, 2006 Report Share Posted June 29, 2006 Dear FORUM, Re: Feasibility of International HIV Testing day Observing an International HIV testing day is a good idea provided the following pre conditions are satisfied. The day should come at the end of a week of HIV/AIDS awareness wherein public education programmes regarding the basics of HIV/AIDS, including treatment options, care and support system if tested postive should be arranged. There should be enough testing facilities. Facilties for the care of those tested postive should be ensured. Incentives for those who come forward for testing should be provided ( as we did for familty planning campaign) Celebrities like Ministers, Film Stars, Cultural leaders should take the lead in testing Ekbal E-MAIL: <ekbal@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 2, 2006 Report Share Posted July 2, 2006 Dear FORUM: As regards the feasibility of Int'l HIV Testing Day, may I submit that our own VCCTC Centers at district headquarters should declare a weeklong program with 2nd December itself to serve as the INTERNATIONAL HIV TESTING DAY as the 1st Dec could be used to motivate people just like Pulse Polio Program. The 2nd of every December be observed for this purpose. The entire week 1st through 7th can be observed as HIV-Week to weaken the stranglehold of this deadly infection. Just like the Pulse Polio celebrities could be roped in to motivate the masses and contribute out of their income just 1 percent each person a year, This way we can go a long way to help the masses in dire need for the right kind of education, counseling and testing. I hope this can be possible and feasible logistically as our VCTCs are already supposed to do the same. Often they under perform and reportedly sell the kits in open market. Dr S TARIQ WALI ANGELZ [iNDIA] TRUST 1-5 UNIQUE PALACE, CIVIL LINES ANOOPSHAHAR ROAD, ALIGARH-202002 UP, INDIA URL: Http://www.angelzindiatrust.org Ph: +91-5713206223 e-mail: <drstwali@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 3, 2006 Report Share Posted July 3, 2006 Dear FORUM, Observing days for a specific cause always helps to draw attention to the issue and in the case of issues like HIV/AIDS it has helped to increase awareness and reduce stigma. In the same light one can assume that HIV Testing Day may help people know more about testing and may also normalise HIV testing. Having said this, it should also be understood that the proposal is not without shortcomings and questions. We must ask whether those who would get tested for HIV on a " Testing Day " will really be those individuals who are into high-risk behaviour? The possibility is very low. Such days are highly symbolic in nature and in the spirit of symbolism many people who are very confident about not being HIV+ve will volunteer to get tested. Thus swelling the number of people who get tested at a particular testing site. But those who are really into high risk behaviour and aware of it would refrain from doing so. It has been observed that those who see themselves as potentially HIV+ve do not go for HIV testing unless they are mentally prepared for it. In the whole bargain a huge amount money will be spent on physical arrangements, personnel, publicity to organise " testing days " where the actual people who get tested would be mostly those not involved in high-risk behaviour. Counselling is the second most important factor. Will we be able to provide quality counselling on such days? It will be very difficult at an emotional level, for a person to find out that he/she is HIV+ve on an International Testing Day when everybody around is in a mood to get as many people tested. The quality of Pre and Post Test Counselling cannot be ensured on such days which assume almost a festive character. Especially in countries like India where the past experience has shown that projects such as these (for example, Family Planning Operation Camps) are driven by the targets, the possibility of this could be very high. HIV testing is futile unless the person is fully made aware of what are the implications of being HIV+ve. One must never forget that being HIV+ve does require several lifestyle changes which are not easy to bring about unless reinforced and encouraged by continuous counselling. If such counselling is not undertaken it can actually lead to a tremendous psychological pressure on the person. It is time that we admit that we have failed to make ARTs available to most of the people living with HIV/AIDS even after many promises and at times sincere efforts by several agencies if one may like to call it so. Countries like India will still have to put in a lot of work to create infrastructure and personnel who can deliver ART efficiently in the remote areas of the country. If we do find a large number of people to be HIV+ve, during testing days, what services will we be able to provide them besides helping them control secondary infections? These are the some of the questions one may have to look at very carefully and have concrete answers to them rather than the usual hogwash. One the whole, one can say that having an International Testing Day may help in educating people about HIV testing and reduce stigma related to testing. But it may not be able to achieve reaching out to people who could be HIV +ve, if that is the objective of the whole exercise. Shailesh Vaite shaileshvaite@... Phone- 09821224191 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 4, 2006 Report Share Posted July 4, 2006 Dear FORUM, I agree to what Shailesh has written in his mail. I wanted to add a few things so that we all can think about the feasibility of International HIV Testing day. The idea of having a HIV Testing day is good. For me its altogether on a different plane and not like the AIDS awareness day or week we observe. There is confusion in our minds about the way in which this day will be observed. Should it be for making people aware about the testing facilities available around them (a logical step after making one aware of the routes of transmission, signs and symproms etc. Also many a times people go to private set up thinking the quality of HIV testing service to be bad, as it is located in the public setup). Or should there be makeshift testing centers to be opend on the day and testing done. Well I do not subscribe to the later as it will result in chaos which my friend has raised in his write up. What appeals to me is that one part of the day might be actual testings being done at the existing VCTC. The other being awareness about testing at various locations. But for sure a large chunck of testings will follow after the observence of the day. It defenitely should not be target based " day " but there has to be a larger bench mark for the whole year (As the Family Health Awareness Week observed twice a year to promote STI treatment seeking behavior). By doing this we increase the utilization of the VCTC service which are better than many of the private lab set ups where there is no pre and post counseling and HIV test is done as a routine blood test. The psychological pressure is more in the later than former. Its high time that we come out of this " high risk behaviour " group mentality. The issue of HIV and AIDS is not restricted to a specific group but is a matter of concern for the whole general population and development of the nation too. There are many interventions for the " high risk groups " working on behaviour change and resulting in utilization of the VCTC services. What we have to worry is that from the general population only the ANC is the lot getting tested for HIV. Such a day can bring in a lot of other segments of the general population in to the picture. With regards to the availiblity of services and facilities like the ARTs, its altogether a different issue to be addressed at different level. My suggestion is that the VCTCs should be open on Sundays and other holidays for peoples convenience and also such a marker day to be observed on a specific Sunday of a particular month. Dr. Athar Qureshi e-mail: <qathar@...> Tel 0-9839911571 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2006 Report Share Posted July 5, 2006 Dear Forum, The High Risk Behaviour bogey raised by the fellow member is trite and outdated. As Dr Qureshi says the earlier we got rid of this mentality the better it would be for all of us. HIV transmission respects no behavioural characterstics- a low or no risk behiour may entail HIV infection. Like MTCT, improperly screened blood transfusions,occupational exposure to healthcare professionals and so on. That one day- say 2nd December every year- be earmarked as International HIV Testing Day with free HIV Screening and counselling. Ist December to be earmarked for HIV/AIDS AWARENESS CAMPAIGN on the World AIDS Day. Next five days could be utilized to documentation, source of HIV in HIV+ detected on the 2nd December and for other related work at the district headquarters. Pulse Polio Campaigns provide a good example to manage the HIV Testing Day. The very first day is Booth Day the next days are utilized for door-to-door campaign and coverage of x-marked homes. Dr Qureshi has supported the under-utilization of VCTC resources. And here is the key to the feasibility of the entire program that I have humbly suggested. Logistically, counselling is provided to those who come to the VCTCs. If we have got sufficient kits available, it is fine. Next five days could always be utilized for intense individal counselling also. The donors of the program will see to it whether the kits are sufficient, trained manpower at VCTC, volunteers, and so on. The hasty approch is not helpful nor is the target-oriented approach. We can implement this program from next year in certain districts and in the coming two years, universal coverage could be ensured at least in India. The gestation period is somewhat 3-4 years. We could very well have this International HIV Testing Day-2nd December to be observed universally from 2010 onwards and in certain high prevalence states from 2007/8 onwards. This program could be run under RURAL HEALTH MISSION also as the funds are aplenty and its penetration is good. Dr S T WALI Chairman Board of Trustees ANGELZ [iNDIA] TRUST 1-5 UNIQUE PALACE Opp Sir Sulaimann Hall Civil Lines ALIGARH-202002 Ph 05713206223 Http://www.angelzindiatrust.org E-mail: <drstwali@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 5, 2006 Report Share Posted July 5, 2006 Dear Forum, Why is HIV testing by itself being promoted as though it is prevention tool? What are we expetced to achieve? Do we want more and more people to test? If so who do we want to go in for testing? And what happens to those who undergo the test and test positive? What support is in place for them? We must understand that HIV prevention and control is very different from the polio eradication program. And we cannot follow similar strategies. In case of the polio eradication program, a child getting the vaccine is the expected outcome, which is a one- time activity. In case of HIV prevention, HIV testing is only one step towards a larger outcome expected- sustained life- long behavior change. Since the expected outcomes are so different, it follows that we need to use different strategies. One of the biggest challenges of the HIV epidemic has been stigma and discrimination. And in the US it was when Magic disclosed his HIV status that there was a surge in HIV testing and care- seeking. And this is seen to have contributed greatly to reducing HIV- related stigma. But in India, even if we do have an HIV testing day, it is doubtful if any of the public icons -be they sportspersons, film stars, politicians-would come forward to testing or disclose their result. And would those who need to test really come on such a day? May be the resources would be put to better use if we focus more on better quality HIV counseling, reducing HIV- related stigma and discrimination and developing mehcanisms for adequate referral and networking among organizations working on HIV/ AIDS issues. Akhila Panchamukhi e-mail<akhila_punch@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2006 Report Share Posted July 7, 2006 Dear Forum, I could not agree more, (with the posting of Akhila Panchamukhi)and would like to add that the people advocating such a testing day do not know a lot about HIV or it's prevention or about behaviour change. Not only do we need to think about what can be done for people who test positive, but what about the people who test negative, will they receive counselling to help them to stay negative or be advised about the window period and be encouraged to come back for a second test? Cheryl Team Leader National HIV and AIDS Support Project, Papua New Guinea e-mail: <ckelly77@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 9, 2006 Report Share Posted July 9, 2006 Feasibility of International HIV Testing day. On Tuesday night, I happened to hear Anjali Gopalan loud in an NDTV show, that corporate philanthropy is biased of profit and the concept of Giving is forsaken. I wish she should have added that the corporate philanthropy and bilateral funding patterns are even taking the concept of voluntarism away from the mindset of people. However, accepting the profit doctrine as today's mantra, I wish to seek opinion of the learned members of the forum on Care, Support, Treatment and its benefit to the nations HIV prevention efforts. I assume that every one will agree in principle that Care, Support and Treatment will contribute to the national effort to halt and reverse the HIV epidemic. But, there is little evidence in support that the fund allocations are translating this with conviction. Though there is a commitment by the Government to provide ART to all those who are eligible for it, there is still hesitation in scaling up, may be for the fear that it will not match up with the prevention efforts. All of us are aware that the distance between WHO estimation of 770,000 people in need of ART in 2004 and NACO's target to provide ARV for 30,000 by people in 2006 and 200,000 people by 2011 is excessively behind. If I am not wrong, there are assumptions that ART centers may not be able to achieve the targets, if targets are scaled up. As on 31st March 37368 people are on ART. There is no data in public domain to check the current situation of demand for ARV in various centers. Even if we go with the argument that there is no demand (Which is not true), is it not a failure on our part to inform the public that ARV is available? Why should we limit our communications strategy for ART program to inter-personal communication? How can we inform the public through any media about ARV and Care and Support services when adequate provisions are not made for it? In short, the scenario indicates that the contribution of care, support and treatment, in preventing the spread of HIV is undermined with out adequate attention. There are millions in India, who do not know their HIV status and spread the infection to their contacts. Do we have a presentable data on the actual number of people who got tested positive in India? If it is available how big, is the difference between the extrapolated 5.2 million? I have come across people telling, why should we get tested when there is no cure. The message that HIV is an incurable, killing disease has gone across to people who have access to media, but nothing is shared about life after HIV infection. What are the incentives offered for people to be tested when there are so many pulling factors that drive them away from the VCTC's. In the context of the discussion on feasibility of International HIV Testing Day, I will reiterate that Access to Treatment, Care and Support and Treatment Education will prove the most fruitful incentive for people to access VCTC services. It is very important to educate the people, what are the benefits in knowing the status early. This education is inseparable from treatment awareness. International HIV Testing Day can become a campaign for treatment awareness and promotion of Positive Prevention. Regards E-MAIL: <awaazdho@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 10, 2006 Report Share Posted July 10, 2006 Dear All, I obsolutely agree with , As VCTC is an entry point for PLHAs it is the most important moment a counselors can impart information on treatment available for HIV. VCTC counselors play a vital role in the life of PLHAs, as when a person tested positive its totally a new begining the person whom they first meet was the counselor. Their is alot of IEC meterials available on HIV/AIDS awareness, so far atleast people are aware of HIV/AIDS and know how to prevent , BUT most of the PLHAs don't where to access treatment ,they don't where ART centre are located. Hand in hand where we advocate for testing we should'nt forget where Care & support services are available if they tested positive. Mike Tonsing Delhi Network of Positive People e-mail <dnpplus@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2006 Report Share Posted July 11, 2006 Dear FORUM: Feasibility of International HIV Testing day. The Forum initiated the discussion on feasibility of observing International HIV Testing Day, to which several distinguished respondents sent in their responses so far. I have very modestly mooted the idea that our own VCTCs are hopefully capable of handling the load as they are presently under performing and given the added support obviously to be lent to them in view of the International HIV Testing Day, we have no reasons to be unduly pessimistic in this regard. We can very well manage them to deliver results. Secondly, I sought to project an outline for the weeklong HIV Testing Week [1-7 December every year] I proposed with the first day of the Week to be reserved as World AIDS Day when we can very well organize programs to bolster up mass consciousness by holding road shows, rallies, seminars, street corner meetings and so on just like we do preceding the Pulse Polio Sundays for Pulse Polio Immunization Campaign. The next day [2nd December every year] could be marked as International HIV Testing Day when our PHCs/CHCs/District Hospitals and VCTCs could be roped in to offer Free HIV Testing and requisite mandatory counseling. The next five days could be utilized to organize post-test counseling, documentation, and also to offer HIV Testing for the left out lot and also to those who might have passed on the HIV infection to those testing positive after taking due care following an interview-based search of the index case. The idea is, among other things, to augment the outreach for improved level of HIV screening. Modalities of these micro-plans could be sorted out locally, nationally and globally. I also suggested that Rural Health Mission could play a key role in holding this mega event of HIV Testing Week to weaken and eliminate the stranglehold of HIV/AIDS. Now, one respondent chose to question the entire premise of testing on the ground that we have insufficient resources for supplying ART to those found HIV+. It boils down to the basic poser: Why should we organize the screening test program at all if cannot treat the person found HIV+!! I cannot foresee a day when we will be sufficiently armed with the ART to take care of all HIV+ persons whether we stop testing for HIV today! The objection seems to have come from the apprehension that the number of HIV+ people are bound to swell once we test the larger cross section of the populace. If we have the mismatch this is a separate issue concerning treatment part. What is emphasized here is screening and diagnostic outreaches, which will ipso facto, cause a far greater amount of mass awareness. Besides, there shall always be a gap between available and optimal levels of counseling as well as availability of ART. On the basis of this fallacious reasoning, we cannot indefinitely postpone the case detection component the key to the HIV Prevention Programs world over. Mixing up issues will not help us a bit. The Pulse Polio Campaign that I chose to illustrate my point was even utilized to teach me [!] that Polio and HIV are different and that vaccine is unavailable for the latter. That didactic comment was unusually amusing for a person like me who is a post grad in Pediatrics! Professor , the doyen of our own Pulse Polio Campaign has very kindly intervened, lent his kind support, and stated,“ it is very important to educate the people, what are the benefits in knowing the status early. This education is inseparable from treatment awareness. International HIV Testing Day can become a campaign for treatment awareness and promotion of Positive Prevention.” Professor ’s wise counsel must not be overlooked and I would like to quote him, “There are millions in India, who do not know their HIV status and spread the infection to their contacts. Do we have a presentable data on the actual number of people who got tested positive in India? If it is available how big, is the difference between the extrapolated 5.2 million?” May I reiterate that my response to the Forum was focused strictly on the feasibility or otherwise of the HIV Testing Day… Other related issues call for a separate debate and must not be brought in to confuse and obfuscate the issue at hand. Dr TARIQ WALI ANGELZ [iNDIA] TRUST 1-5,UNIQUE PALACE CIVIL LINES, ANOOPSHAHAR ROAD ALIGARH-202002, UP, INDIA URL: Http://www.angelzindiatrust.org Ph: +91-5713206223 e-mail: <drstwali@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2006 Report Share Posted July 17, 2006 Dear forum, I agree with what Prof Ekbal said about involving celebrities. Mass media campaigns announcing the date and increasing towards the said date must be completed. Campaigns that people of all walks of life must think about testing. We must also break this myth that only economically weaker sections of our community are HIV positive. Campaigns that anyone maybe HIV positive and if you test positive there are services available must be emphasised. However In our effort to get many people to test, we must not forget to provide quality and confidential counselling and testing. Confidential out - referrals in case of those who are positive must be ensured. Assuring confidentiality and campaigning against stigma and discrimination must both go hand in hand. Magdalene Magdalene Jeyarathnam Counselling Consultant Tamil Nadu State AIDS Control Society e-mail: <magdalene.jeyarathnam@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 17, 2006 Report Share Posted July 17, 2006 Re: Feasibility of International HIV testing day Dear forum, There can be no question that the organization of an International HIV testing Day will aid in promotion of testing and in HIV prevention. In India, only a small percentage (perhaps only less than 10%) of the 5.2 million estimated to be HIV infected knows their HIV status. Not knowing their HIV status hinders people from seeking care and also from spreading the infection to others. Currently, there is no imaginative campaign on self risk assessment and testing. Although a large number of VCTCs have been established throughout the country, attendance is poor. If a well designed testing campaign is conducted, there is no doubt that more at risk people will volunteer for testing. But, if we want to expand counseling and testing on a large scale, we also have to take counseling and testing facilities to their door steps; through outreach counseling facilities employing NGOs and arranging for transporting blood samples for testing at a VCTC. Easy availability of counseling and testing will result in far more uptake. It is essential to have a good promotional campaign which presents counseling and testing in an acceptable manner. The counseling, testing and related services have to be of good quality. The testing centres should have good linkages with NGOs/hospitals/ART centres etc, so that the beneficiaries can access their services, when required. A testing campaign spread over a fortnight or a month even, would be much better than token testing for a day. It would have greater effect, if done along with the world AIDS day activities. Dr. M. Prasanna Kumar e-mail: <mpkumar@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 Dear FORUM, Re: Feasibility of International HIV Testing day. We have to relook at our goal / aim. What is it that we want to do about HIV/AIDS? And then look at the ACTION plans. Where will HIV/AIDS testing take us on tha path to that goal. And even if both of them fit well we must not forget that sometimes we set our goals completely wrong and therefore enjd up being on the path we should never have been on. That is why 'one must keep questioning even one's own assumptions, beliefs' (not my thought but Galileo's). AIDS/HIV is unfortunately has not remianed a mere infection of the body. Unfortunately, the social stigma takes a needless toll on people affected with it. That perhaps is the bigger problem today, for death is inescapable but social discrimination sure is, if we can stand against it. Mere testing of HIV/AIDS to identify positive people may actually not be of much use. Unless we have set other things right. Dr. Parvez Imam Director f-20 Communications e-mail: <drparvezimam@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 25, 2006 Report Share Posted July 25, 2006 Dear FORUM, I believe that we should not test people for any disease if we cannot give them treatment, same applies to HIV also. Look at other communicable diseases ; we had Effective , Universal , Free or Affordable treatment for LEPROSY, TB [ MDT & DOTS ] and with this HOPE in mind people came out voluntarily seeking COUNSELLING and TESTING. Without any Hope why should 'one 'come for TESTING and if found 'positive' to be OSTRACISED and STIGMATISED by all and sundry. As long as we cannot provide Aproppriate treatment at all Health posts [free of charge] under NACO we should not go on testing people indiscriminately and brand them. It is for this that I am not sure if the International Testing day will do justice mathews m e-mail: <docmathews@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 25, 2006 Report Share Posted July 25, 2006 Dear Forum, Though it sounds excellent to have such a day been observed internationally, one needs to take some of the following issues also into account while actually going head with such an idea: 1. If the day is been declared due to x,y,z reasons and pressures, how objectively will programmes and policy makers in different countries be able to implement the same without hindering other aspects of testing like maintaining confidentiality and anonymity of patients, in that case one has to think alternatives for the abbreviation VCCTC? 2. How are programmes and governments going to garner infrastructure, manpower and money for the same 3. How is programme going to face the uphill task of providing care and support to people who turn out to be positive, if the ethics dimension is added to the same. 4. What about prevention and awareness building amongst population who are found positive how are programmes going to handle those. And a lot many such major and minor issues which need to be addressed first, rather than putting across a day for testing, foresight regarding such issues which will further complicate things if different regions and countries due to lack of adequate infrastructure and trained personnel needs to be the top priority for the programme and policy makers internationally, nationally and locally. SAJU JOSEPH Research Supervisor, MAAS-CHRD, Aundh, Pune - 411007. e-mail: <saju_333@...> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 26, 2006 Report Share Posted July 26, 2006 Dear Forum How many of the NGO staff working in either prevention or care have gone for testing. Why shouldn't they speak about it. A group which is more knowledgable and expereince Dr.Manorama e-mail: <pmanorama@...> Quote Link to comment Share on other sites More sharing options...
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