The Integrated Counselling and Testing Centre is a gateway, a one stop shop, for a host of related services in HIV/AIDS prevention and care.  The concept of ICTC evolved in Tamil Nadu from evidence-based experience of HIV - AIDS prevention and care programmes in this state over the last two decades.

In the mid-‘80s, when HIV-AIDS was first found to affect people in Tamil Nadu, one of the immediate responses from the state was voluntary counselling and testing. Various groups at risk were identified and people at various levels were encouraged to get counselled by professionals on how to avoid getting the infection as well as on what to do if infected. Thus, voluntary counselling and testing (VCTC) centres were the first pro-active prevention centres TANSACS set up.

It was in 2005 that VCTC, PPTC and several other allied services offered in Tamil Nadu by the government were integrated to evolve the ICTCs, Integrated Counselling and Testing Centres.  ICTCs  have strong referral services:early access to medical supervision, treatment and care for opportunistic infection and STIs, linkages to blood banks and sites for prevention of parent to child transmission and access to condoms as well as harm reduction programmes .

Treatment services like anti-retroviral therapy (ART),  diagnosis  and treatment of tuberculosis,  testing and treatment for sexually transmitted infections,  reproductive diseases and any other health care requirements that a HIV patient may need are linked by the ICTCs with relevant services.

ICTCs provide psychosocial support and crisis counseling to people living with, and directly affected, by HIV. A network of support institutions  like community care centers and drop in centers access ICTCs.

The ICTC also ensure linkages with the public-sector three-tier  health care system. ICTC links clients with legal aid services, welfare services and facilitates access to public distribution systems, nutrition schemes, insurance schemes, employment and alternative employment schemes, education schemes and child care services and care homes.         

To increase people’s access to ICTCs, Tamil Nadu has established the highest number of such centres  in the nation.

There are 797 ICTCs spread across Government Medical College hospitals, Government head quarters hospitals, Taluk  head quarters hospitals, Government Primary Health Centres, prisons, corporation and municipal health posts, bus terminus, railway stations  and private hospitals.  

Tamil Nadu was one of the first states which saw the need to extend AIDS care to its prisoners. There are 9 ICTCs established in all the central prisons in Tamil Nadu. Convicts, under-trials and others interned in all the central prisons in Tamil Nadu now have the opportunity to receive HIV counselling and access preventive services. It has been observed that convicts, among the many marginalised groups, show high  prevalence of HIV i.e. as high as 1.5%. This clearly indicates the need for urgent and focused intervention among those interned in prisons.    
There are also 11 mobile ICTCs.  TANSACS’ experience as service provider tells us that often, High Risk/Vulnerable population are less likely to access fixed facilities. Among the main reasons is the distance of the ICTC at the time of need. TANSACS has, therefore, planned to provide HIV prevention and control initiative in the urban, rural and tribal areas through these 10 Mobile ICTCs.  Six new mobile ICTCs were added in the year 2010-11.

2.Counsellors:  Each ICTC is provided with trained and informed, gender-sensitive, counselors pre-disposed to supporting people living with HIV and those directly affected.  He/She ensures that each visitor to the ICTC is provided with pre-test counselling, post-test counselling and follow-up counselling in a friendly atmosphere. The counsellor maintains strict confidentiality. Additional counsellors are available in ICTCs with high number of visitors desiring HIV tests.