Developing Regional HIV T&C Policy Framework

1. Developing Regional HIV T&C Policy Framework Lali Khotenashvili Communicable Diseases Unit, WHO Regional Office for Europe

2. HIV in Europe, Stockholm Plan of talk Development process Key principles Ways forward

3. HIV in Europe, Stockholm Process Comprehensive review and analysis of theevidence Extensive consultation process

4. HIV in Europe, Stockholm Scaling up HIV T&C must be linked with efforts to achieve UA HIV testing is never a goal in itself At the same time as access to testing is increased, access to ART should be improved and equal access guaranteed Need for OST to support ART Access to comprehensive HIV prevention

5. HIV in Europe, Stockholm Expanded T&C must be tailored to different settings & populations T&C scale up efforts should include PITC for people presenting with signs and symptoms & those with suspected primary HIV infection implementing PITC in facilities providing STI services; services for most-at-risk populations; antenatal, childbirth & postpartum services

6. HIV in Europe, Stockholm Expanded T&C should be tailored to different settings & populations(cont’d) T&C scale up efforts should meet the needs of most-at-risk and vulnerable populations Innovative approaches should be adopted expanded beyond health care settings Efforts to increase access & uptake should include prisoners & detainees UNODC/WHO Policy Brief on “HIV testing and counselling in prisons and other closed settings”

7. HIV in Europe, Stockholm Rapid HIV tests should be used, where appropriate

8. HIV in Europe, Stockholm “3 Cs” should always be observed Informed, voluntary consent should be obtained providers should receive training and education clear legal and policy frameworks that stipulate the specific age and/or circumstances in which minors may consent to HIV testing are needed privacy and confidentiality laws should be in place

9. HIV in Europe, Stockholm Ensuring supportive social, policy, legal framework Without the following components, efforts are unlikely to reach their objectives: Community preparedness and social mobilization adequate resources & infrastructure codes of conduct for testing providers Methods of redress for patients

10. HIV in Europe, Stockholm Critical issues to be considered Real protection from discrimination & abuse Costing, budgeting, implementing key initiatives & programmes: legal audits & law reform, legal support services, know your rights campaigns, campaigns against stigma & discrimination, training of health-care professionals, judges, prosecutors, police, prison staff etc.

11. HIV in Europe, Stockholm Key principles (cont’d) HIV testing policies & practices should be reviewed to eliminate non-voluntary forms of testing Assessment & consultations to formulate plans for T&C expansion Status of the epidemic & response (in particular, access to treatment and prevention) Ensure representation of all stakeholders

12. HIV in Europe, Stockholm M&E HIV T&C should be carefully monitored & evaluated Not just scale up, but T&C quality and consequences (linkage to and uptake of services v exclusion) Capacity building efforts

13. HIV in Europe, Stockholm Ways forward Preparing final draft Wide public consultation Developing final version Publishing

14. HIV in Europe, Stockholm Acknowledgements Ralf Jürgens, consultant Reviewers Participants in consultation meetings