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I need to present a seminar so give me content for my ppt on these topic from psm park

Reading File

Finding Sources

Reading File

Finding Sources

Reading File

Here is the complete PPT content for your seminar on HIV Testing & Diagnosis, sourced directly from Park's Textbook of Preventive and Social Medicine.

SLIDE DECK: HIV Testing & Diagnosis

SLIDE 1 - Title Slide

HIV Testing & Diagnosis

HIV Testing Strategies
ICTC (Integrated Counselling and Testing Centre)
HIV Counselling (Pre- and Post-Test)
Diagnostic Tests
HIV Screening in Special Populations

Source: Park's Textbook of Preventive & Social Medicine

SLIDE 2 - HIV Testing: Overview & Purpose

Why HIV Testing Matters

HIV counselling and testing services in India run since 1997 under the National AIDS Control Programme (NACP)
Goal: Identify people living with HIV as early as possible and link them to prevention, care and treatment
Introduction of ART services in 2004 gave a major boost to testing programmes
The "Test and Treat" policy aims toward UNAIDS fast-track targets (90-90-90 by 2020):
- 90% of PLHIV know their status
- 90% of those are on ART
- 90% of those have viral suppression

SLIDE 3 - HIV Testing Strategies

Two Main Approaches

1. Voluntary Counselling and Testing (VCT) / Client-Initiated Testing:

Person seeks testing of their own free will
Fully voluntary, confidential

2. Provider-Initiated Testing and Counselling (PITC):

Medical provider advises/recommends testing
Routine offer with "opt-out" option
Used in ANC clinics, TB patients, STD clinics

WHO Five C's Governing All HIV Testing:

Consent - informed, voluntary
Confidentiality - results protected
Counselling - pre and post-test
Correct test results - quality assured
Connection - linkage to care and treatment

SLIDE 4 - HIV Testing Strategies (Continued)

Testing Approaches by Population

Population	Testing Strategy
High-risk groups (IDU, MSM, FSW, TG)	Unlinked anonymous with informed consent
Bridge population (migrants, truckers)	Unlinked anonymous at STD clinics
Pregnant women (ANC)	Routine opt-out testing
TB patients	PITC - routine HIV testing

Sentinel surveillance conducted once in 2 years
Sample size: 250 (high-risk), 400 (ANC)
Testing protocol: Two-test protocol

SLIDE 5 - ICTC: Introduction

Integrated Counselling and Testing Centre (ICTC)

Primary facility for HIV counselling and testing in India
A person is counselled and tested either:
- Client-initiated (of own free will), or
- Provider-initiated (advised by medical provider)

Functions of ICTC:

Early detection of HIV
Provision of basic information on modes of transmission and prevention
Promoting behavioural change and reducing vulnerability
Linking PLHIV with HIV prevention, care and treatment services

Scale: More than 15,000 ICTCs across India (as of recent data)

SLIDE 6 - Types of ICTC Facilities

Classification of ICTCs

1. Fixed Facility ICTCs

a. Standalone ICTC (SA-ICTC):

High client load
Full-time counsellor + laboratory technician
Located in medical colleges, district hospitals, sub-district hospitals, CHCs

b. Facility-Integrated ICTC (F-ICTC):

Set up at block level (24x7 PHCs)
Existing health facility staff trained in counselling and testing
Logistic support from DAC (Department of AIDS Control)
Public-Private Partnership (PPP)-ICTCs also established

2. Mobile ICTC:

Van with room for examination, counselling, blood sample collection
Team: Health educator/ANM + Counsellor + Laboratory technician
Serves hard-to-reach areas with flexible hours
Provides: HIV testing, STI/RTI syndromic management, ANC, immunization

SLIDE 7 - HIV Counselling

Pre-Test Counselling

Conducted before the HIV test. Key components:

Explanation of the purpose and nature of the test
Information on HIV transmission modes and prevention
Discussion of risk behaviours
Implications of a positive vs negative result
Obtaining informed consent
Addressing fears, stigma, confidentiality concerns
Preparing the client emotionally for results

Key principle: Testing is a gateway to HIV prevention, treatment, care and support services

SLIDE 8 - HIV Counselling

Post-Test Counselling

Conducted after the result is given. Differs by result:

If HIV Negative:

Reinforce risk reduction behaviours
Discuss window period (need for re-testing if recent exposure)
Encourage continued safe practices

If HIV Positive:

Emotional support and disclosure counselling
Information on disease progression, treatment options
Referral to ART centre and other PLHIV support services
Partner notification and testing guidance
Positive living advice (nutrition, safe sex, adherence)
Linkage to PPTCT services (if pregnant)

SLIDE 9 - Diagnostic Tests for HIV

Laboratory Tests & Their Significance

Test	Purpose & Significance
HIV ELISA	Screening test; Sensitivity >99.9%; Repeatedly reactive results must be confirmed
Western Blot	Confirmatory test; Specificity >99.99% when combined with ELISA; Indeterminate in early HIV, HIV-2, autoimmune disease, pregnancy
Absolute CD4 count	Most widely used predictor of HIV progression; Risk of OI high if CD4 <200 cells/μL
CD4 lymphocyte %	More reliable than absolute count; Risk high if <14%
HIV Viral Load	Measures actively replicating HIV; Correlates with disease progression and ART response
p24 Antigen	Indicates active HIV replication; Positive before seroconversion and with advanced disease
β2-Microglobulin	Macrophage-monocyte stimulation marker; Level >3.5 mg/dL = rapid progression
CBC	Anaemia, neutropenia, thrombocytopenia common with advanced HIV

SLIDE 10 - Diagnostic Tests: Testing Protocol

Standard Testing Algorithm in India

Two-test protocol used for sentinel surveillance
Screening with ELISA (high sensitivity)
Reactive samples confirmed with Western Blot (high specificity)
Rapid tests available for point-of-care testing at ICTCs
Dried Blood Spot (DBS) specimens used at TI project sites

Window Period:

Period between infection and detectable antibodies
Usually 2-12 weeks (most within 6 weeks)
Person may be infectious but test negative
Re-testing advised if recent high-risk exposure

SLIDE 11 - HIV Screening in Special Populations

1. Pregnant Women (PPTCT Programme)

PPTCT (Prevention of Parent-to-Child Transmission) started in India in 2002
Routine offer of HIV counselling and testing to all pregnant women with "opt-out" option
Spouse involvement encouraged
Evolution: Single-dose NVP (2002) → Multi-drug ARV (2012) → Lifelong ART "Option B+" (2013 onwards)
Lifelong ART for all HIV+ pregnant and breastfeeding women regardless of CD4 count or WHO clinical stage
Goal: Eliminate mother-to-child transmission of HIV

SLIDE 12 - HIV Screening in Special Populations

2. TB Patients

HIV testing of TB patients jointly implemented by NACP and RNTCP since 2007-08
PITC used routinely through the intensified TB-HIV package
States with high HIV prevalence cover ~90% TB patients for HIV testing
HIV testing offered upstream during evaluation for TB symptoms (since October 2012)
Expedites HIV detection within 2-4 weeks of TB positivity
Case fatality rate among HIV-TB co-infected patients: 13-14% vs <4% in HIV-negative TB cases

3. HIV-Exposed Infants

All infants born to HIV-positive mothers screened
Early Infant Diagnosis (EID) at 6 weeks using DNA PCR

SLIDE 13 - HIV Screening in Special Populations

4. High-Risk Groups (HRG) and Bridge Populations

Group	Strategy
Injecting Drug Users (IDU)	Targeted interventions (TI), unlinked anonymous testing
Men who have Sex with Men (MSM)	TI projects, sentinel surveillance
Female Sex Workers (FSW)	TI projects
Transgender (TG)	TI projects
Single Male Migrants (SMM)	STD clinic-based testing
Long Distance Truckers (LDT)	TI project-based testing
STD clinic attendees	Syndromic management + HIV testing

5. Community-Based HIV Screening

Frontline health workers (ANMs) conduct testing at sub-centre level
Aims to offer HIV testing to every pregnant woman in the country

SLIDE 14 - HIV Testing Services: Hierarchy in India

Levels of HIV Counselling and Testing Services:

State/District Level - Standalone ICTCs at medical colleges, district hospitals
Sub-District Level - F-ICTCs at sub-district hospitals, CHCs
Block Level - F-ICTCs at 24x7 PHCs; PPP-ICTCs
Village/Community Level - Mobile ICTCs, community-based screening by ANMs

SLIDE 15 - Summary

Key Takeaways

HIV testing is voluntary, confidential and guided by WHO 5 C's
Two main strategies: VCT (client-initiated) and PITC (provider-initiated)
ICTC is the backbone of HIV testing in India - Fixed (Standalone/Facility-integrated) and Mobile
Counselling is integral - pre-test (consent, risk assessment) and post-test (support, linkage)
Diagnosis uses ELISA (screening) followed by Western Blot (confirmation); CD4 count guides prognosis
Special population screening: Pregnant women (PPTCT), TB patients (PITC), HRGs (targeted interventions), infants born to HIV+ mothers
Test and Treat policy and 90-90-90 targets drive the national programme

All content sourced from: Park's Textbook of Preventive and Social Medicine (Park's PSM), Department of AIDS Control / NACP guidelines

Notes for your presentation:

The slides follow the exact order of your assigned topics
Slide 9 has the full diagnostic tests table - great for quick recall during viva
Slide 11-13 cover all special populations comprehensively
You can split Slide 6 and Slide 9 into two visual slides each for better readability

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