The foundation of effective PMTCT programs is the identification of HIV-positive pregnant women and linking them and their babies with appropriate HIV-related treatment, care and support services. Provider initiated HIV counseling and testing (PICT), now generally considered a standard component of medical care, is a strategy used to maximize identification of women in need of PMTCT services. Pregnant women are encouraged by a health care provider to be tested for HIV as soon as possible in each new pregnancy. Repeat testing later in pregnancy is recommended among HIV-negative women in generalized epidemics. HIV counseling and testing in labor or shortly thereafter is also encouraged for pregnant women of unknown status who present at a health facility to deliver their babies.

In line with international guidelines, PICT is not mandatory; every pregnant woman has the right to decline the test. Test results must always be treated confidentially and results will not affect a women’s access to health care or other support services.