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HIV voluntary counseling and testing (VCT) services provide a critical entry point to both HIV/AIDS prevention and care and support of infected and affected individuals. Over the past decade, the scope of VCT has evolved from a diagnostic tool for symptomatic patients to an essential component of HIV prevention efforts. With improved interventions to reduce mother-to-child transmission (MTCT), increased access to more affordable antiretroviral (ARV) drugs, and effective prophylactic treatment of opportunistic infections (OIs), providing VCT to the general public has become an urgent priority.

There is clearly a need to strengthen and expand VCT services in resource-poor countries, where 95 percent of new HIV infections occur. Though significant efforts are being made to expand the scope and scale of VCT programs worldwide, the vast majority of people are unaware of their HIV status. Knowledge of one's HIV status plays the most significant role in modifying behavior to either remain uninfected or to prevent infecting current or future partner(s). Despite its importance, there are several barriers to widespread expansion of VCT services. These include lack of government involvement, limited financial resources, and fear of stigma and discrimination. The dearth of appropriately trained counselors and health providers presents a primary obstacle to establishing and maintaining high-quality VCT services.

HIV Voluntary Counseling and Testing (VCT): A Reference Guide for Counselors and Trainers is an extremely valuable tool to address these challenges. It equips users with the competence and confidence to provide comprehensive, quality, and culturally appropriate services. Increased quality of services will lead to greater acceptance and utilization of VCT services. The reference guide includes discussion of: training and skills-building materials; sensitive HIV testing issues; basic counseling concepts; skills and coping mechanisms; standardized strategies to promote behavior change; and quality assurance systems. This diverse collection of information will benefit all involved in HIV/AIDS prevention, care, and support efforts, including health care providers, counseling professionals, community workers, and people living with HIV/AIDS.

The authors have distinguished this reference guide from others by highlighting the interactions among prevention, care, and support activities and emphasizing the link between VCT and the HIV/AIDS prevention-to-care continuum. This is an important step in combating the spread of the epidemic and mitigating its impact on those infected and affected by HIV. This is a valuable contribution to the future of effective HIV VCT and to enhancing prevention, care, support, and treatment efforts.