ICTC stands for Integrated Counseling and Testing Centre.

As the HIV problem intensifies, the issues of care and support for affected individuals, and prevention of HIV transmission to those who are not affected, becomes even more critical.

Integrated Counseling and Testing (ICT) is now seen as a key entry point for a range of interventions in HIV prevention and care. It provides people with an opportunity to learn and accept their HIV sero status in a confidential and enabling environment and to cope with the stress arising out of HIV infection.

ICT should become an integral part of HIV prevention programs, as it is a relatively cost-effective intervention in preventing HIV transmission.

The potential benefits of ICT are:

• Earlier access to care and treatment.
• Providing factual information about HIV/AIDS and clearing misconceptions.
• Reduction of fear and stigma through counseling.
• Creating enabling environment for PLHA.
• Emotional support.
• Better ability to cope with HIV related anxiety.
• Improved health status through good nutritional advice.
• Motivation to initiate or maintain safer sexual practices and behavior change.
• Prevention of HIV related illness.
• Motivation for drug related behavior.
• Safer blood donation.
• Motivating HIV infected person to involve spouse/partner for future spread and care.

ICTC is not a place just for testing a sample for HIV, but much more than that. One of the basic elements involved is a confidential discussion between the client and the trained counselor and the focus is on emotional and social issues related to possible or actual HIV infection.

The aim of the ICTC is to reduce psycho-social stress and provide the client with information & support necessary to make decisions; therefore it needs a private and peaceful setting.
Separate enclosures for male & female clients have been set up to provide confidential environment for encouraging disclosure and providing IPC.

For the effective functioning of the ICTCs, two trained counselors and one laboratory technician have been provided in each ICTC.

In order to ensure that the result of the HIV test is given on same day to the individual after post-test counseling, Rapid HIV Test Kits have been supplied to these centers or the client is asked to meet the same counselor for post test counseling on appointed date.

Waiting space, trained Microbiologist/Pathologist, training to staff functionaries of ICTC, two trained counselors and one laboratory technician have been provided in each ICTC.

In order to ensure that ICTCs provide quality counseling services, stress has been laid on pre-placement in-service training of counselors & technicians by master trainers & resource persons.

Orientation training is also conducted for these functionaries.

In order to make its services more user-friendly following efforts are being made:

• ICTCs are located in easily accessible areas mostly in OPDs.
• Informed consent in the local language is taken before HIV testing. Clients are informed about the nature and consequences of HIV test before their consent is taken. It is emphasized that testing should not be forced but left at the will of the client.
• It is emphasized that counselors should not be rotated from centre to centre, and from one day to another since the rapport between the counselor and client is very essential.
• Adequate supply of condoms is made available in these counseling centers. Individuals attending the ICTC are also made aware about the outlets from which they can get condoms under various schemes.
• Counseling is integrated into other services, including STI, antenatal and RCH clinics.
• A referral system has been developed in consultation with NGOs, community based organizations, hospitals and PLWA networks.
• Counselors are provided adequate training and ongoing support and supervision to ensure that they give good quality counseling and avoid burnout.
• Linkages with NGOs for social support, follow-up counseling and care for those tested sero positive, are emphasized.
• Innovative ways of scaling up ICT services and making them more accessible and available is the endeavor.
• There is an emphasis on making it more client-friendly and service based, by augmenting the following services:

                    - Anti retroviral drugs in PPTCT
                    - Anti-tubercular treatment in HIV-TB co-infection
                    - Free treatment of STI & opportunistic infections
                    - Follow up services & networking among patients living with AIDS.