Counselling And Testing For HIV Prevention

Counselling and testing for HIV serves many worthy purposes especially as a gateway to valuable medical and other services for those who test positive. But what about prevention? A recent comment called for universal counselling and testing in Africa largely for prevention. However such an ambitious goal impels us to consider its merits for prevention especially in the pivotal generalised epidemics in southern and eastern Africa that are driven by multiple and concurrent sexual partnerships. Intuitively knowing ones HIV status should lead to prevention. But in reality a test result alone is not enough. Effective and sustained behavioural change is needed both for those who test positive and the much larger and different group that tests negative. Undoubtedly counselling and testing helps some individuals reduce risk but currently its merits to substantially affect generalised epidemics are limited. (excerpt)