Integrated Counseling and Testing Centre

 

Basic Services Division (BSD)

  • Integrated Counselling & Testing Centers ( ICTC): 36
  • Facility Based -ICTC’s (F-ICTCs): ( Kmr 41; Jmu- 16) Total 57
  • State Reference Laboratory (SRL) – 2 (EQAS & Reverse EQAS)
  • Prevention of Parent To Child Transmission (PPTCT) –
  • HIV/TB Collaboration : Collaborative activities between RNTCP & NACP.

HIV testing in ICTCs in Jammu and Kashmir State Year wise

Year

Total Clients tested for HIV

Clients found HIV positive

 

General Clients

Pregnant women

Total

General Clients

Pregnant women

Total

2008-09

27,101

26,308

53,409

397

07

404

2009-10

30,106

28,917

5,9023

479

22

501

2010-11

25,774

34,256

60,030

343

17

360

2011-12

33,555

50956

84,511

426

26

452

2012-13

39442

55114

94556

380

7

387

2013-14

43059

37144

80203

362

15

377

2014-15

48434

40204

81995

351

13

364

2015-16

69689

60670

117963

364

19

383

2016-17

72686

62353

135039

327

19

346

2017-18

68409

59023

127432

365

10

375

 

Integrated Counselling and Testing Centre

Introduction:-
HIV counselling and testing services were started in year 1997. There are now more than 8000 counselling and testing centres (ICTCS) in India. An individual who is infected with Human Immunodeficiency virus (HIV) will not develop the acquired immunodeficiency syndrome (AIDS) immediately. The Immune system of the individual will wage a consistent and prolonged war with the virus, right from the day of infection, delaying the onset of AIDS by many years. The time lag between infection and manifestation of signs and symptoms of AIDS is approximately 5-7 years. It is therefore important that an individual who is HIV infected should aware of his/her status otherwise he/she could unknowingly transmit virus to others on one hand and devoid of the care support and treatment facilities of NACP (National AIDS Control Programme) on the other hand. The only way to diagnose the presence of HIV (Human Immunodeficiency virus) is through a simple blood test. Under new HIV treatment narrative 90-90-90. By 2020 90% of all people living with HIV will know their HIV status.

 

What is an integrated counselling and testing centre (ICTCS):-
An ICTC is a place where a person is counselled and tested for HIV on his free will (Client initiated) or as advised by a medical provider (provider initiated).
The main function of an ICTC include:-

  1. Early detection of HIV
  2. Provision of basic information on modes of transmission and prevention of HIV/AIDS for promoting behavioural change and reducing vulnerability.
  3. Link HIV Positive to care support and treatment services.
  4. Follow up counselling.
  5. Prevention of parent to child transmission(PPTCT)
  6. Cross referral-TB/STI/TI-NGO/DIC

What are different types of ICTCs

  1. Fixed facility ICTCs
  2. Mobile ICTCs

Fixed facility ICTCs are those ICTCs that are located within an existing health care facility/Hospital /Centre.

A fixed facility ICTC can be of two types

  1. Stand-Alone ICTC (SA ICTC)
  2. Facility Integrated ICTC (FICTC)

Stand Alone ICTC: Having full time counsellor and a laboratory technician who under take HIV counselling and HIV testing respectively having a computer and internet assess facility for on line monthly reporting under Strategic Management Information system (SIMS). These ICTCs are established in every District, in the District Hospital and GMC (Government Medical College) Jammu and Srinagar, Kashmir along with other Hospitals in Jammu and Kashmir District.

Facility Integrated testing and counselling centre (FICTC): The ICTC which doses have full time staff and provide HIV counselling and testing services as a service along with other services of the health Department. Existing staff such as auxiliary nurse midwife (ANM)/ staff nurse & laboratory technician ( LT) are being trained in counselling and Hiv testing activities respectively. Such facilities are to be establish in Government sub district Hospital/community Health centre and 24*7 PHC where client load is more as well as in private and public sector Hospitals. The FICTC are supported by NACO to the extent of

  1. Supply of rapid HIV testing Kites
  2. Training of existing stuff
  3. Quality assurance
  4. IEC material

MOBILE ICTC:- It is observed that higher risk /vulnerable population are less likely to assess fixed facility ICTCs due to several impediments the most important being distance and timing. A Mobile ICTC consisting of a team of paramedical health care providers (A Health Educator/ANM counsellor and Lab. Tech. can set up a temporary clinic with flexible working hours in hard to reach areas where services are provided ranging from regular health check-up, syndromic treatment for STI/RTI ( Sexually Transmitted infection/Reproductive trait infection) and other minor ailments, Antenatal care, immunizations as well as counselling and testing services. A Mobile ICTC will consist of a van with a room to conduct general examination and counselling and a space for collection and processing of blood samples etc.

Testing under an ICTC

  • It is not the mandate of an ICTC to Counsel and test everyone in the general population.
  • There are Subpopulation who are more vulnerable or practice high risk behaviour.
  • These sub – populations include sex workers and their clients, Men who have sex with men (MSM), transgender, injecting drug users (IDUs), Truckers, Migrant workers, spouses and children of man who are prone to risky behaviour r.
  • HIV prevalence levels are typically higher among these sub populations than in the general populations
  • Medical Providers also refer patients who have a history of risky behaviour or have signs and symptoms suggestive of HIV/AIDS for Counselling and testing to an ICTC.
  • Any individual who is self motivated at his free will can avail Hiv Counselling and Testing services in an ICTC.

Where can an ICTC be locate

  1. ICTCs should ideally be located such that they provide maximum access to at- risk/vulnerable populations.
  2. It is important to ensure that facilities for counselling and testing be located as close to the people as possible.
  3. Under the National AIDS Control Programme, Phase II, Integrated (Voluntary) and Confidential Counselling and Testing Centres have been established at district level Government hospitals and Medical Colleges
  4. These earlier Voluntarily Counselling and Testing Centres (VCTCs) and facility providing prevention to Parent to Child Transmission of Hiv/AIDS (PPTCT) are now remodelled as a hub to deliver integrated Services to all Clients under one roof and renamed as “ INTEGRATED COUNSELLING AND TESTING CENTREs” (ICTCs)

Purpose of HIV Testing

    Information is useful for prophylaxis, medical management and treatment of HIV and related
  • To assure blood safety and donation safety
  • To assess the efficacy of targeted intervention in a defined cohort.
  • To monitor trends of epidemic (sentinel surveillance etc.)
  • Identification of asymptomatic individuals (practicing high risk behaviour)
  • To plan personal and family’s future if the result is positive.
  • To motivate for behaviour modification through counselling amongst those who test negative and who practice high risk behaviours.
  • To induce behaviour change and prevent transmission by counselling in those who are test positive
  • To diagnose clinically suspected cases
  • peace of mind of individuals practicing high risk behaviour

General Principals/ Test Procedure in HIV Testing

  1. Inform Consent after pre test counselling for HIV testing
  2. CONFIDENTIALITY
  3. It should be part of the overall comprehensive and preventive programme
  4. Testing should be technically sound and appropriate. All testing should precede pre test counselling and followed by post test counselling.

HIV Testing to be done by three different tests.

  1. Kit-1
  2. Kit-2
  3. Kit-3

Input Under NACP

  1. Counsellor
  2. Laboratory Technician
  3. Infrastructure development Fund- Onetime Cost
  4. HIV Kits
  5. Grants for Consumables, furniture & Contingency

Monitoring and Supervision

  1. Over all Monitoring and supervision by NACO & JKSACS
  2. Overall in charge (ICTC) in Medical College :HOD Microbiology Department
  3. Over all In charge(ICTC) PPTCT CENTRE HOD Gynaecology Department
  4. ICTC - in charge in District Hospital: Medical Superintendent/Medical Officer (Assigned Duty)
  5. ICTC in charge in other Hospitals : Respective Heads of the institutions

               

               

ICTCs in Jammu & Kashmir State
Total ICTC in J&K state   =       36
New proposed ICTC         =       06
Total proposed FICTC      =       25
Total proposed Mobile ICTCs=  02 

SNo
Name of the ICTC
 District
ICTCs OF JAMMU DIVISION
1 ICTC, GMC Jammu Jammu
2 ICTC(PPTCT) SMGS HospitalJammu
3 ICTC Govt Hospital,Gandhi Nagar Jammu
4 ICTC, District Hospital, Sarwal Jammu
6 ICTC, Sub-Police Hospital, Chenni Jammu
7 ICTC, ASCOMS, Sidhra, Jammu Jammu
7 ICTC, SDH, Akhnoor, Jammu
8 ICTC, District Hospital, Kathua Kathua
9 ICTC, District Hospital, Rajouri Rajouri
10 , District Hospital, Udhampur Udhampur
11 ICTC, District Hospital, Poonch Poonch
12 ICTC, District Hospital, Samba Samba
13 ICTC, District Hospital, Ramban Ramban
14 ICTC, District Hospital, Doda Doda
15 ICTC, District Hospital, Kishtwar Kishtwar
16 ICTC, District Hospital Reasi


SNo. Name of ICTC District
1 ICTC GMC Srinagar Srinagar
2 ICTC (PPTCT) LD Hospital Srinagar
3 ICTC, JLNM Hospital, Rainawari Srinagar
4 ICTC, SKIMS Srinagar, Srinagar
5 ICTC, Medical College, SKIMS, Bemina Srinagar
6 ICTC, Poilice Hospital, Zeewan Srinagar
7 ICTC, District Hospital, Baramulla Baramulla
8 ICTC, Sub-District Hospital, Uri Baramulla
9 ICTC, District Hospital, Kulgam Kulgam
10 ICTC, District Hospital, Ganderbal Ganderbal
11 ICTC, District Hospital, Budgam Budgam
12 ICTC, District Hospital, Handwara Handwaa
13 ICTC, District Hospital, Shopian Shopian
14 ICTC, District Hospital, Pulwama. Pulwama
15 ICTC, District Hospital, Bandipora Bandipora
16 ICTC, MCH, Anantnag Anantnag
17 ICTC Kupwara Kupwara
18 ICTC, District Hospital, Leh Leh
19 ICTC, Sub-Distt. Hospital, Nubra Leh
20 ICTC, District Hospital, Kargil Kargil

Inspite of un-favorable conditions of the State, the number of voluntary visitors have increased manifold because of the sustenance & dissemination of HIV/AIDS awareness at grass root level. Accordingly, People started to attend ICTCs and the more HIV +ve cases are expected to be identified over a period.

HIV Testing And Positivity Among General Clients


HIV Testing And Positivity Among Pregnant Women



 

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