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

  • Author(s): Metsch, LR
  • Feaster, DJ
  • Gooden, L
  • Matheson, T
  • Mandler, RN
  • Haynes, L
  • Tross, S
  • Kyle, T
  • Gallup, D
  • Kosinski, AS
  • Douaihy, A
  • Schackman, BR
  • Das, M
  • Lindblad, R
  • Erickson, S
  • Korthuis, PT
  • Martino, S
  • Sorensen, JL
  • Szapocznik, J
  • Walensky, R
  • Branson, B
  • Colfax, GN
  • et al.
Abstract

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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