Voluntary counseling and testing (VCT) for HIV is an essential link between HIV prevention and HIV care and support. VCT promotes and sustains behavior change, and links with interventions to prevent mother-to-child transmission (PMTCT), prevent sexually transmitted infections (STIs), and prevent and treat tuberculosis (TB) and other opportunistic infections (OIs). VCT also facilitates early referral to comprehensive clinical and community-based prevention, care and support services, including access to antiretroviral therapy (ART). VCT improves quality of life and may play a pivotal role in reducing stigma.

VCT is now a priority intervention in many countries. In these countries, VCT is conducted as a collaborative effort among the host government, development partners (donors) and local and international organizations. VCT is conducted independently or jointly by public and private sector organizations, including non-governmental organizations (NGOs) and community-based organizations (CBOs).

Though there are many successful VCT programs, limited practical guidance exists on how to design, implement and monitor VCT services. This guide was developed to address this gap and is based on Family Health International's experience in assisting countries to establish VCT services.

A Guide to Establishing Voluntary Counseling and Testing Services for HIV focuses on three levels:

• The national level: Implementation at this level is a tripartite partnership among the host government, development partners (donors) and the technical group providing technical management to an implementing agency
• The district or NGO level
• The site level (implementing agency): The implementing agency depends on the chosen model of service delivery but can include institution-based, clinic-based, stand-alone or mobile sites, or a combination of the above.

A Guide to Establishing Voluntary Counseling and Testing Services for HIV is intended for governments, development partners and public and private sector organizations, including NGOs, as they begin to establish VCT programs and services. In this document, we refer to the organization establishing VCT services at the site level as the "implementing agency." This guide is meant to be just that—guidance to be used or adapted depending on the specific country epidemiological, political, social, cultural and economic context.