Apart from community counseling HST offers pre-test and post- test counselling at its VCCTC and various referral linkages in Mumbai Metro. As part of community led initiative, members from the community are trained in the counselling skills.

A pre test counseling form provided by MDACS was being used by counsellors at all VCCT centers. It was soon realized that the counseling form provided was not covering various aspects that were relevant for the MSM population. Thus a need arose to design a new in house counseling form specific to MSM / Tg populations. A detailed formatted questionnaire, designed by HST and LTMG Hospital and approved by MDACS and USAID/ FHI, is now being used during the pre-test counselling in addition to the MDACS Counseling Register. With the help of this form, the counsellor notes personal history, demographic profile, in-depth sexual history, condom usage with partners, intravenous drug use, and blood transfusion in past, awareness about HIV/AIDS/STIs, past history of any STIs, their treatment and impact.


VCCTC Protocol

After the pre test counseling form is filled, informed consent is obtained from the client stating that the client voluntarily consents to go for a HIV test. Once the written consent is obtained, the client proceeds to the clinic where the doctor examines the client. The doctor, before examining the client, makes sure that the client has understood the information provided in the counseling session and the examination includes a thorough physical check-up for the presence of any STIs and syndromic treatment is provided if needed.

If the client has given an informed consent the Lab Technician does the blood collection for HIV and VDRL test and issues him the referral card. The client is then advised to collect his report in three days time on production of his valid referral card. The client collects his report from the counsellor after a detailed post test counseling. For negative results it may include motivating the client to remain negative, stress on consistent condom usage, emphasis on risk reduction and nutrition counseling. The client is advised to come for a regular follow up and is given specific instructions to come for a repeat test if he is observed under window period.

For positive results counseling includes dealing and acceptance of results, emphasis on positive and healthy living including nutrition counseling, issues of marriage, spouse notification, consistent condom usage, risk reduction behaviour, information on care and support and treatment facilities and other relevant issues that emerge in the session. The counsellor may also refer the client to the Mental Health Professional / Psychiatrist. The client is advised to avail services of the Safe Sailors Club, a support group established for positive MSM.

An individual file is made for every HIV positive client at LTMG hospital and necessary investigations are conducted as may be considered appropriate by the head of the department of LTMG Hospital or as desired by the client. A nutritive supplement is provided to all HIV positive clients at the VCCT center and other referral centers of HST.


VCCTC data:

Year	Pre test	No of tests done	Post Test	No of HIV +
1st April 2001 to 31st March 2002	988	958	484	128
1st April 2002 to 31st March 2003	1267	1267	536	188
1st April 2003 to 31st March 2004	1298	1283	586	211
1st April 2004 to 31st March 2005	1154	1108	694	146
1st April 2005 to 31st March 2006	1495	1563	751	140
1st April 2006 to 30th Sept 2006	1119	608	1051	102
Total	7321	6787	4102	915

STI data: