Zimbabwe shifts from voluntary HIV testing to provider-initiated testing in response to epidemic

Zimbabwe has shifted from a voluntary HIV testing system to a provider-initiated system in which medical professionals incorporate HIV testing into routine medical exams with the permission of their patients, Zimbabwe's The Herald reports.

Owen Mugurungi, head of the AIDS and TB unit at the Ministry of Health and Child Welfare, said provider-initiated counseling and testing aims to strengthen HIV service programs.

Mugurungi said that under the new system, HIV screening will be provided as part of routine hospital services and patients can opt out of tests. "We took that decision because we understood that there were missed opportunities for people to get tested," Mugurungi said, adding, "It also helps both the service provider" and patients to "plan effectively on either living positively or maintaining a negative status." He said the new system would preserve consent, counseling and confidentiality requirements outlined by the World Health Organization and UNAIDS.

The introduction of the provider-initiated system was discussed in 2004 and was followed by pilot studies in 2005. "So far we are on track," Mugurungi said, adding, "The pilot project proved successful, and we are getting support from nongovernmental organizations."

According to The Herald, the provider-initiated concept is similar to a testing program that is being implemented in Zimbabwe's prevention of mother-to-child HIV transmission initiative. Under the initiative, all pregnant women are tested for HIV unless they decline, Mugurungi said, adding that pregnant women also are encouraged to bring their partners for testing. "We discovered that it would be difficult for women to approach their husbands after they had been tested, but if they come together, it lessens the burden and tension in the family," he said. According to Mugurungi, changes in Zimbabwe's HIV testing policies will not lead to mandatory testing. "We will never introduce mandatory testing," he said, adding that "instead we are looking forward to mandatory offer of HIV testing for service providers" (The Herald, 10/27).