HIV testing doesn’t start in the lab. Throughout the Zanmi Lasante network, it begins with a conversation with a member of the Community Education Teams, known by the acronym NEC. Before the blood sample is drawn, each patient participates in a counseling session designed to explain the testing process, answer their questions, and prepare them for the various possible outcomes. This conversation also provides a confidential space to address fears and misconceptions related to HIV.
For many patients, the decision to get tested raises practical concerns. Some fear the result, while others worry about the confidentiality of the test, how their loved ones will react, or what steps to take if the result is positive. The role of NECs is to listen to these concerns and provide information that is clear enough to enable each person to make informed decisions about their health. Their work continues after the test, when the result is communicated and explained.
Data collected at the Saint-Marc SSPE illustrate the importance of this support throughout the care journey. In July 2026, 807 people underwent HIV testing there, and all received pre- and post-test counseling. For 31 of them, the test revealed an HIV infection. Their support then shifted in nature: the NECs helped them understand their diagnosis and connect them with the services responsible for their ongoing care. Two NECs are currently carrying out this work within the SSPE and in the surrounding communities.
Sertil Darling recently joined the Zanmi Lasante team after several years of experience as a peer navigator. For her, the work of an NEC goes beyond simply conveying information. Each patient must be prepared to receive their results, whatever they may be, and then helped to understand the options available to them. Her experience allows her to tailor her conversations to the concerns expressed by each individual. This preparation also facilitates the work of other professionals involved in screening and care.
“The work done by the NEC makes our job easier. In any case, the patient must go through the NEC before coming to the lab, because the preparatory session is essential to the process,” explains Anne Marie Fabienne, a medical technologist. This collaboration allows laboratory staff to receive patients who already understand the testing process and its purpose. After the results are communicated, the NEC steps in again to verify that the person understands the information received and knows which services to contact.
The continuity of this support becomes particularly important when a positive result is confirmed. In addition to medical information, the patient may need psychological or social support. The NECs then serve as a liaison with the professionals responsible for the patient’s ongoing care.
“The NECs play a vital role; they are the ones who establish contact between us and patients who test positive so that we can provide the necessary support.”
Bellerice Lirisemond, social worker.
The care pathway thus brings together the NECs, the laboratory, the nurses, and social services. Each team intervenes at a specific stage, with a common goal: to help the patient understand their result and access the services they need. For Ms. Louvena Siméon, the nurse in charge of the program, the NECs’ close relationship with patients fosters a better understanding of testing and helps build the trust necessary for continued care.
The results recorded in Saint-Marc therefore do not merely reflect the fact that 807 people had access to screening. They demonstrate how the model implemented within the Zanmi Lasante network combines testing with structured psychosocial support. Counseling is not a supplementary service added to the process. It is an integral part of the quality of testing and ensures that each person receives their results along with the information and guidance they need.
Maintaining accessible testing services requires trained staff, functional equipment, and teams capable of supporting each patient beyond the test results. Your support helps Zanmi Lasante preserve access to comprehensive care for the communities that need it.