“…However, in Kenya (as elsewhere), considerable variation in testing uptake and return for follow up between different testing sites has been reported, indicating that specific site factors have an impact on the patient experience (Anand et al, 2009). A number of qualitative studies highlight that patients can feel pressured into testing, are mistrustful of healthcare staff or report poor quality care (Delva, Mutunga, Quaghebeur, & Temmerman, 2006;Groves, Maman, Msomi, Makhanya, & Moodley, 2010;Hamilton et al, 2008;Painter et al, 2004 (National AIDS and STD Control Programme, 2006). However, a recent evaluation of the PITC national training programme found that only 30% of health facilities were fully implementing PITC citing staff shortages, lack of space and low staff morale as associated factors (Kathambana et al, 2008).…”