Circular No. 01/2015/TT-BYT guiding counseling on HIV/AIDS prevention and control at healthcare facilities

CIRCULAR

Guidelines for HIV/AIDS Prevention and Control Counseling at Healthcare Facilities

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Pursuant to Clause 2, Article 22 of the Law on Prevention and Control of Infection with Human Immunodeficiency Virus (HIV/AIDS) dated June 29, 2006;

2. To firmly grasp the Party’s policies, viewpoints, and State’s policies and laws regarding health and related fields to apply them in health management and guidance at the local level. 31 the 8 the Government's Decree No. 16/2012/ND-CP on the functions, tasks, powers, and organizational structure of the Ministry of Health;

1. Positive HIV test results may only be notified when such results have been confirmed by a laboratory that has been authorized by the competent authority to conduct confirmatory testing for HIV-positive cases as stipulated in Decree No. 75/2016/NĐ-CP dated July 1, 2016 of the Government on conditions for conducting HIV tests and Decree No. 155/2018/NĐ-CP dated November 12, 2018 of the Government amending and supplementing certain provisions related to investment and business conditions under the management of the Ministry of Health.

The Minister of Health issues this Circular guiding HIV/AIDS prevention and control counseling at healthcare facilities.

PART I

GENERAL PROVISIONS

Article 1. Scope of Regulation

This Circular stipulates the content and organization of HIV/AIDS prevention and control counseling, pre-test and post-test counseling at healthcare facilities.

Article 2. Interpretation of Terms

In this Circular, the following terms are understood as follows:

1. Window period is the time during which a person infected with HIV has not yet produced sufficient antibodies to be detected by standard tests.

2. Indeterminate HIV test result refers to the inability to determine the presence of HIV antibodies in blood, which may indicate either no HIV infection or an infection during the window period.

3. Advisory staff is a person who has been trained in HIV/AIDS at medical training institutions or has undergone counseling training on HIV/AIDS prevention and control at continuous training centers in accordance with Circular No. 22/2013/TT-BYT dated August 9, 2013, issued by the Minister of Health, guiding continuous training for healthcare workers (hereinafter referred to as Circular No. 22/2013/TT-BYT).

Article 3. General Principles

1. Ensuring the confidentiality of information of the counselee.

2. Ensuring counseling in accordance with the content and procedures prescribed by law.

3. Reporting positive HIV test results shall be carried out in accordance with Circular No. 01/2010/TT-BYT dated January 6, 2010, issued by the Minister of Health, stipulating responsibilities and procedures for reporting positive HIV test results, and Circular No. 09/2012/TT-BYT dated May 24, 2012, issued by the Minister of Health, guiding epidemiological surveillance of HIV/AIDS and sexually transmitted infections.

4. Ensuring referral of individuals with positive HIV test results to services for care, treatment, and prevention of HIV transmission.

Chapter II

CONTENT OF HIV/AIDS PREVENTION AND CONTROL COUNSELING

Article 4. Content of counseling on prevention in HIV/AIDS prevention and control

General counseling content and specific counseling content for certain groups regarding prevention in HIV/AIDS prevention and control shall be implemented in accordance with Article 5 and Article 6 of Circular No. 06/2012/TT-BYT dated April 20, 2012, issued by the Minister of Health, stipulating conditions for establishment and content of activities for organizations providing counseling on HIV/AIDS prevention and control.

Article 5. Content of pre-test and post-test HIV counseling

1. Pre-test counseling:

a) Introducing and discussing reasons for counseling and HIV testing;

b) Discussing potential risks of HIV transmission;

c) Exchanging and explaining the significance and benefits of HIV testing and knowing the HIV test results.

2. Post-test HIV counseling:

a) Counseling for individuals with negative HIV test results:

- Explaining the test results and the significance of the window period;

- Advising and exchanging measures to reduce the risk of HIV transmission;

- Counseling on the necessity of participating in support services for mental health, psychological, social, medical care, and HIV transmission prevention.

b) Counseling for individuals with confirmed positive HIV test results:

- Notifying the positive HIV test results;

- Providing mental and psychological support counseling;

- Advising on how to disclose the HIV status to spouse, sexual partners, or shared syringe users and encouraging the counselee to refer these individuals and their children (if any) for counseling and HIV testing;

- Counseling on measures to prevent HIV transmission to others and legal responsibilities for preventing HIV transmission to others;

- Counseling on the benefits and necessity of participating in HIV care, treatment, and transmission prevention services.

c) For individuals with indeterminate HIV test results:

- Explaining the significance of the test results;

- Reassessing the most recent exposure risk period and advising on the need for retesting HIV after 14 days.

Chapter III

ORGANIZATION OF ACTIVITIES

1. Personnel conditions: having at least one counselor.

2. Conditions regarding infrastructure and equipment:

a) Ensuring confidentiality, ventilation, and adequate lighting. In cases where group counseling is conducted, there must be sufficient seating corresponding to the number of people being counseled;

b) Having the minimum necessary equipment for counseling activities, including a desk, chairs, and communication materials for counseling purposes.

Article 7. Forms of Counseling

a) Group counseling;

b) Couple counseling or counseling for two individuals with sexual relations;

c) Individual counseling.

2. The selection of counseling forms depends on the scale of patients and the specific needs of each patient. Group counseling shall not be applied for post-HIV test counseling for patients with positive HIV test results.

Article 8. Counseling Process for HIV/AIDS Prevention and Control

1. In cases where the subject proactively requests:

a) They will be counseled on HIV/AIDS prevention measures: healthcare staff will provide counseling to the patient according to Article 4 of this Circular;

b) They will be tested for HIV: if the healthcare staff meets the conditions stipulated in Clause 3, Article 2 of this Circular, they will provide counseling to the patient according to Article 5 of this Circular. If the healthcare staff does not meet the conditions stipulated in Clause 3, Article 2 of this Circular, they must refer the patient to a counselor.

2. During medical examination and treatment, healthcare staff have the responsibility to counsel or refer the patient to a counselor for HIV testing counseling when encountering the following subjects:

a) Individuals with high-risk behaviors;

b) Individuals with tuberculosis;

c) Individuals with sexually transmitted infections;

d) Individuals infected with hepatitis C virus;

đ) Pregnant women;

e) Children of HIV-infected individuals;

g) Individuals exposed to HIV;

h) Patients who have been clinically examined and undergone ancillary tests but the cause of illness has not been identified or have clinical symptoms suspected of HIV infection as specified in Decision No. 3003/QĐ-BYT dated August 19, 2009 of the Minister of Health on issuing Guidelines for Diagnosis and Treatment of HIV/AIDS.

3. After pre-HIV test counseling, if the counselee agrees to undergo an HIV test, guide them to:

a) Sign consent for the HIV test in their medical record if the counselee is an inpatient;

b) Fill out and sign the confirmation form for HIV testing according to the model attached to this Circular if the counselee does not fall under the category specified in Point a of this Subsection.

4. For individuals under 16 years old or lacking civil capacity, counseling must be provided to their parents or legal guardians (hereinafter referred to as the legal representative). If the legal representative consents to the HIV test, guide them to sign the required documents as stipulated in Clause 3 of this Article.

5. During the counseling process, counselors have the responsibility to introduce the counselee to appropriate healthcare services for HIV care, treatment, and prevention based on the actual condition of the counselee:

a) Medical services: diagnosis, treatment, and opportunistic infection prophylaxis, antiretroviral therapy; prevention of mother-to-child transmission of HIV; diagnosis and treatment of tuberculosis; sexually transmitted infections; methadone maintenance treatment for drug addiction; reproductive health care;

b) Harm reduction interventions and other social support services in HIV prevention.

Chapter V

RESPONSIBILITIES FOR IMPLEMENTATION

Article 9. Responsibilities of the National Center for HIV/AIDS Prevention and Control

1. Guide the implementation of counseling activities to prevent and control HIV/AIDS in healthcare facilities.

2. Develop and submit to competent authorities specialized materials serving counseling activities to prevent and control HIV/AIDS.

3. Propose a list of units responsible for training counseling on prevention and control of HIV/AIDS for healthcare workers in healthcare facilities under the Ministry of Health.

4. Organize inspections, supervision, and evaluation of the results of counseling activities to prevent and control HIV/AIDS nationwide regularly or at random.

Article 10. Responsibilities of Provincial Departments of Health

1. Direct healthcare facilities in the province to implement counseling work to prevent and control HIV/AIDS in healthcare facilities in accordance with the guidance of this Circular.

2. Designate units within their management authority to be responsible for training counseling on prevention and control of HIV/AIDS in compliance with the provisions of this Circular and Circular No. 22/2013/TT-BYT, or request units specified in Clause 3, Article 9 of this Circular to organize training counseling on prevention and control of HIV/AIDS for healthcare workers in healthcare facilities under their management when necessary.

3. Inspect, audit, and summarize and conclude the situation of implementing counseling activities to prevent and control HIV/AIDS in the province.

Article 11. Responsibilities of Healthcare Facilities

1. The following healthcare facilities shall be responsible for organizing counseling on prevention in HIV/AIDS prevention and control for organizations and individuals upon request:

a) Preventive healthcare facilities with functions to prevent and control HIV/AIDS;

b) Diagnostic and treatment healthcare facilities: general hospitals, specialized hospitals with functions to treat infectious diseases, specialized clinics for HIV/AIDS prevention and control.

2. If a healthcare facility conducts HIV testing techniques, it shall be responsible for:

a) Organizing counseling on prevention in HIV/AIDS prevention and control for organizations and individuals upon request;

b) Organizing pre-test and post-test counseling for HIV;

c) Fully implementing statistical reporting systems according to regulations for the central agency collecting data reports on HIV/AIDS prevention and control in the area.

ChapterVI

IMPLEMENTING PROVISIONS

Article 12. Cross-referencing Provisions

In cases where referenced documents in this document are replaced or amended, they will be implemented according to the replacing document or the amended document.

Article 13. Effective Date

1. This Circular takes effect from April 15, 2015.

2. The following provisions are abolished from the date this Circular takes effect:

a) Decision No. 647/QD-BYT dated February 20, 2007 of the Minister of Health on Guidelines for Voluntary HIV Counseling and Testing;

b) Clause 5, Article 1 and the phrase "Clause 5" in Clause 2, Article 3 of Circular No. 33/2011/TT-BYT dated August 26, 2011 of the Minister of Health stipulating mandatory HIV testing in certain necessary cases for diagnosis and treatment of patients.

Article 14. Transitional Provisions

Healthcare facilities currently organizing counseling activities to prevent and control HIV/AIDS may continue operations but must strengthen and improve to meet the requirements of this Circular before January 1, 2017.

Article 15. Responsibility for Implementation

The Head of the Ministry's Office, Director of the National Center for HIV/AIDS Prevention and Control, Heads of Departments, Directors of Censuses, General Directors under the Ministry of Health, Heads of agencies and units directly under the Ministry, Directors of Provincial Health Departments, and Heads of health agencies under Ministries and sectors are responsible for enforcing this Circular.

During implementation, if difficulties arise, units and localities should report to the Ministry of Health for research and resolution./.