DSS areas where Prevention of Mother to Child Transmission (PMTCT) or Antiretroviral (ARV) therapy is offered will also have Voluntary Counseling and Testing (VCT).  All three of these services need to be monitored for coverage by equity quintile. 

VCT involves interacting at an individual level between the researcher, or service provider, and the study subject or service recipient.  There are basically two issues targeted by VCT providers. Counselors strive to achieve either preventive goals or treatment/psychosocial goals.  For preventive goals there are mainly two preventative outcomes addressed;- primary prevention and secondary prevention. Primary prevention targets those who test negative or respond to not being involved in doing something negative. Here the counselor would strive to facilitate individual behaviour change in such a way that the subject does not change his/her ways. Secondary prevention targets those who test positive or respond to being involved in doing something negative to society. Here the counselor strives to facilitate individual behaviour change to prevent infection

Some studies involve VCT for achieving either treatment or psychosocial support objectives. Studies that involve treatment of un-curable diseases, domestic violence fall in this category.

In both situations there is a need to have trained counselors with skills to manage the situation ensuring confidentiality and building rapport between the subject and them that would enable follow up in order to register behaviour change.

Some VCT packages for HIV involve three phases, pre-testing, pre- result giving and post-result giving. All these stages address the issues at hand from a different perspective (e.g. from explaining to the subject the advantages of knowing the results, preparing the subject by discussing all the result possibilities and implications, giving the results, and monitoring and support procedures after the result giving).

All sites that plan to have a VCT component should first consider the type of VCT needed and the capacity to achieve it.