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Implementing rapid HIV testing with or without risk-reduction counseling in drug treatment centers: results of a randomized trial.

2012 Jun

Journal Article

Metsch, L.R.; Feaster, D.J.; Gooden, L.; Matheson, T.; Mandler, R.N.; Haynes, L.; Tross, S.; Kyle, T.; Gallup, D.; Kosinski, A.S.; Douaihy, A.; Schackman, B.R.; Das, M.; Lindblad, R.; Erickson, S.; Korthuis, T.; Martino, S.; Sorensen, J.L.; Szapocznik, J.; Walensky, R.; Branson, B.; Colfax, G.N.

Am J Public Health






Adult; Counseling; Female; Follow-Up Studies; HIV; HIV Infections; Humans; Male; Mass Screening; Middle Aged; Program Evaluation; Risk Reduction Behavior; Substance Abuse Treatment Centers; United States; Unsafe Sex

OBJECTIVES: We examined the effectiveness of risk reduction counseling and the role of on-site HIV testing in drug treatment.METHODS: Between January and May 2009, we randomized 1281 HIV-negative (or status unknown) adults who reported no past-year HIV testing to (1) referral for off-site HIV testing, (2) HIV risk-reduction counseling with on-site rapid HIV testing, or (3) verbal information about testing only with on-site rapid HIV testing.RESULTS: We defined 2 primary self-reported outcomes a priori: receipt of HIV test results and unprotected anal or vaginal intercourse episodes at 6-month follow-up. The combined on-site rapid testing participants received more HIV test results than off-site testing referral participants (P<.001; Mantel-Haenszel risk ratio=4.52; 97.5% confidence interval [CI]=3.57, 5.72). At 6 months, there were no significant differences in unprotected intercourse episodes between the combined on-site testing arms and the referral arm (P=.39; incidence rate ratio [IRR]=1.04; 97.5% CI=0.95, 1.14) or the 2 on-site testing arms (P=.81; IRR=1.03; 97.5% CI=0.84, 1.26).CONCLUSIONS: This study demonstrated on-site rapid HIV testing's value in drug treatment centers and found no additional benefit from HIV sexual risk-reduction counseling.

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