Percent of persons who complete the HIV testing and counselling cycle in last 12 months

Export Indicator

The percentage of the general population aged 15-49 years receiving an HIV test, the results, and post-test counselling, in the last 12 months.
What it measures

This indicator is a composite indicator of the coverage and of the quality of T&C services within a country.  To some degree it also assesses the demand for HIV testing and counselling, assuming that the demand is being met by current services. Finally, it provides information on the proportion of the population that knows their HIV status.
 
HIV testing and counselling are important entry points for prevention and care needs.  It is therefore important to measure the number of people who access these services, as an indicator of the number of people who could potentially benefit from prevention and care. 
 
When the indicator is collected in a survey, respondents should be asked whether they were tested and received the results in the previous 12 months.  This should be reported as one indicator with the number tested and counselled as the numerator and the number of respondents as the denominator.
 
If this indicator is collected in a health management information system or through facility reports it should be reported as a cascade identifying the following information:

Number of individuals who received pre-test counselling and/or pre-test information sufficient to ensure informed consent
Among those who received pre-test counselling, the percent actually tested
Among those who were tested, the percent who received their results Among those who were tested, the percent who received post-test counselling

Rationale
Numerator

The number of people surveyed who received HIV test, the results, and post-test counselling in the last 12 months.

Denominator

Number of people 15-49 years surveyed (depending of sample unit used for the various sources of information).

Calculation
Method of measurement

The following methodologies are recommended:
1. Household survey
By asking respondents whether they have ever been tested and then asking whether they have been tested in the last 12 months, this indicator can be captured in a nationally-representative manner.

2. Health Management Information Systems (HMIS)
Ideally, information for this indicator can be collected by reviewing data collected at the local level(s) and available through the HMIS at the national level. 

3. Health Facility Survey
Where HMIS are not fully operational, the use of health facility surveys with a testing and counselling component in all relevant units/departments may be necessary.
 
It is necessary to stratify the indicator by how these services are delivered.  Specifically, by integrated (i.e. testing for diagnostic purposes) and vertical (i.e. stand alone VCT) service delivery.
It will be interesting to present this indicator by the source of the services to see which facilities are more successful in attracting clients.

Measurement frequency

Periodic

Disaggregation

Age group: 15 years - 24 years

Education: N/A

Gender: Male, Female

Geographic location: N/A

Pregnancy status: N/A

Sector: Private, Public

Time period: N/A

Type of orphan: N/A

Vulnerability status: N/A

Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

T&C services are often not performed within discreet departments (i.e. out-patient or in-patient departments), thus there is the potential for duplicate reports of the same individual. Household surveys can minimize duplicate reports because only the individual is reporting. In some instances, because of the various points of HIV testing and counselling services, it may be difficult to link testing to counselling through facility records unless a strong record-tracking system is in place. There are a number of limitations to this indicator. For example, if someone knows they are HIV positive, there is no need for the individual to have had a test in the past year. In addition if someone has not been exposed to any risk of HIV in the past year, there is no need for the individual to be tested. Current levels of testing are so low in most countries that it might also be useful to look at the percent ever tested.

 

Further information