Sarah, the distinction is what for me gets a little bit greyish. Like in the case of HIV - Provider initiated routine testing with and an 'opt-out' approach is practiced due to high HIV prevalance in my country (Botswana). However as is the case with many routine screenings it is not implemented optimally. But basically how it works is any patient presenting at a public facility must be given information on HIV and then offerred the test (If they do not have a known status already) regardless of what they are presenting with. Of which if they consent they will undergo pre-test counseling before being tested onsite (mostly) using a rapid test. They will then be post-test counseled to recieve the result and then supported with counselling or treatment if they need it.
For pregnant women there is even a greater number that get tested (~98%) through the PMTCT program which seeks to identify all mothers at risk of transmitting the virus perinatally. Once they are found they are offerred prophylaxis or ART therapy depending on thier CD4 levels.
So my dillema is in trying to understand whether both these cases present screening for risk of for disease.
