Send to

Choose Destination
See comment in PubMed Commons below
Bull World Health Organ. 2012 Sep 1;90(9):652-658B. doi: 10.2471/BLT.11.100818. Epub 2012 Jun 27.

From caution to urgency: the evolution of HIV testing and counselling in Africa.

Author information

  • 1HIV/AIDS Department, World Health Organization, Geneva, Switzerland.



To describe recent changes in policy on provider-initiated testing and counselling (PITC) for human immunodeficiency virus (HIV) infection in African countries and to investigate patients' experiences of and views about PITC.


A review of the published literature and of national HIV testing policies, strategic frameworks, plans and other relevant documents was carried out.


Of the African countries reviewed, 42 (79.2%) had adopted a PITC policy. Of the 42, all recommended PITC for the prevention of mother-to-child HIV transmission, 66.7% recommended it for tuberculosis clinics and patients, and 45.2% for sexually transmitted infection clinics. Moreover, 43.6% adopted PITC in 2005 or 2006. The literature search identified 11 studies on patients' experiences of and views about PITC in clinical settings in Africa. The clear majority regarded PITC as acceptable. However, women in antenatal clinics were not always aware that they had the right to decline an HIV test.


Policy and practice on HIV testing and counselling in Africa has shifted from a cautious approach that emphasizes confidentiality to greater acceptance of the routine offer of HIV testing. The introduction of PITC in clinical settings has contributed to increased HIV testing in several of these settings. Most patients regard PITC as acceptable. However, other approaches are needed to reach people who do not consult health-care services.

[PubMed - indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Scientific Electronic Library Online Icon for PubMed Central
    Loading ...
    Support Center