HIV voluntary counseling and testing (VCT) is often considered the first step for initiating prevention and/or therapy. One of the strategies for addressing the AIDS epidemic is to give people an opportunity to know their HIV status so that they can take precautions to avoid further spread and receive early therapy if they are infected [53, 54] . However, even in developed countries, many atrisk people do not take VCT. A national British survey in 2000 showed that only one-third of IDUs had VCT in the past 5 years [55] . About one-fourth of the 0.8 to 0.9 million infected people in the United States remain unaware that they are HIV positive [54] . In China, there is a large discrepancy between reported (about 100,000) and estimated (about 1 million) cumulative HIV/AIDS cases thus far. Many at-risk individuals do not seek out standard HIV counseling and testing services. The stigma associated with drug use and HIV/AIDS and fear of arrest or knowing a positive result can be major barriers to access to VCT. A survey among 840 pregnant women and 780 health professionals in Yunnan Province -an epicenter of the HIV/ AIDS epidemic in China -found prevalent negative attitudes toward HIV/AIDS. Twenty-three percent of health professionals and 45% of pregnant women thought HIV was a disease of "low class and illegal" people; 48% of health professionals and 59% of pregnant women thought that HIV positive individuals should not be allowed to get married; and 30% of the health professionals were not willing to treat an HIV-positive individual [56] . Cost of traditional VCT, low awareness of risk factors for HIV infection, distance, and inconvenience in time also may prevent access to VCT. Possible solutions include development of outreach programs to offer anonymous testing and counseling to those at heightened risk of HIV infection and adoption of new technologies such as rapid saliva testing and counseling strategies to improve the outreach and efficacy of programs.