The lost children of universal access – issues in scaling-up HIV testing and counselling

Bibliographic Data

ID12893677
AuthorsVincent Wong (0000-0002-7012-3511, World Health Organization), Iain J MacLeod (0000-0001-5608-634X), Charles F Gilks (0000-0002-8953-3123, World Health Organization), D L Higgins (World Health Organization), Siobhan Crowley (World Health Organization, corresponding author)
Year2006
Volume1
Issue1
Pages44-55
Publication date2006-07-01
Open AccessNo
TypeARTICLE
VenueVulnerable Children and Youth Studies (JOURNAL)
Journal identifiersISSN: 1745-0136 • E-ISSN: 1745-0128
PublisherRoutledge (PUBLISHER • GB)
DOI10.1080/17450120600700004
OpenAlexW1994573250
LanguageEN
Citations received6
References cited6

This descriptive study is based upon information and data gathered from a convenience sample and review of national human immunodeficiency virus (HIV)/voluntary counselling and testing (VCT) policies; a review of existing recommended or selected tools and guidance; and informants working with HIV testing and counselling (HTC) and children at an implementation or policy level selected through purposive, snowball sampling. Questionnaires captured data on problems, strategies and legal frameworks on HTC provision to children in multiple countries and regions. The policy review of 20 high-prevalence countries revealed that while 84% distinguished identified children as a specific subgroup affected by HIV, only 35% of national policies offered details on HTC and children. Fifty-seven key informants (53% implementers, 48% policy-level) from 25 countries in four regions responded; 93% stated problems existed in the area of HTC and children and further specific guidance was needed on children in the following issues: informed consent (63.2% of respondents), child-counselling (54.4%), discrimination/stigma/child's rights (42.1%), diagnosis/laboratory issues (38.6%), disclosure (33.3%), service delivery (31%), access (29.8%), policy (23%) and confidentiality (21%). No geographic differences were found. Eighty guidance publications were reviewed that covered some of these issues. While some guidance, policies, strategies and tools have been developed around HTC and children, findings suggest that in many countries significant gaps and corresponding needs exist if children are to benefit from the move to Universal Access. Policy makers, programmers, implementers and monitoring efforts need to better directed. National policies must be updated to specify and reflect the technical and policy needs relating to diagnosis of HIV in children, and offer implementers specific directives related to consent, confidentiality and counselling needs. Stakeholders at international and country levels need to work to improve and update existing guidance; implementers must be updated in current best practices

Business · Confidentiality · Developing country · Economic growth · Environmental health · Family medicine · Human immunodeficiency virus (HIV · Medical education · Nonprobability sampling · Political science · Psychiatry · Service (business · Service delivery framework · Snowball sampling · Stigma (botany · Adolescent Sexual and Reproductive Health · HIV/AIDS Research and Interventions · Law · Medicine · Poverty, Education, and Child Welfare · Psychology

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