HIV counseling and testing: its evolving role in HIV prevention

Area of Science:

• Public Health
• Epidemiology
• Biomedical Science

Background:

• The development of HIV antibody screening tests like ELISA marked a significant advancement in AIDS prevention.
• A national HIV counseling and testing (HIV CT) program was established in 1985, funded by the CDC, to target individuals at risk of HIV infection or transmission.

Purpose of the Study:

• To describe the key features, events, lessons learned, and future challenges of the national HIV CT program.
• To analyze the program's history using the framework of public health infrastructure.
• To provide insights relevant to implementing new HIV prevention technologies.

Main Methods:

• The study reviews the 11-year history of the national HIV CT program.
• It utilizes the concept of public health infrastructure to analyze program development.
• Key features, policy debates (e.g., mandatory testing), and lessons learned are described.

Main Results:

• The national HIV CT program's implementation involved significant policy debates, particularly concerning mandatory testing.
• The program's evolution highlights challenges in integrating biomedical and behavioral HIV prevention strategies.
• Lessons learned emphasize the importance of public health infrastructure for effective program delivery.

Conclusions:

• The 11-year history of the national HIV CT program offers valuable insights for future public health initiatives.
• Understanding the challenges faced by this program is essential for the successful rollout of new HIV prevention technologies.
• The study underscores the critical role of public health infrastructure in managing and adapting prevention programs.