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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, Lisa R
  • Feaster, Daniel J
  • Gooden, Lauren
  • Matheson, Tim
  • Mandler, Raul N
  • Haynes, Louise
  • Tross, Susan
  • Kyle, Tiffany
  • Gallup, Dianne
  • Kosinski, Andrzej S
  • Douaihy, Antoine
  • Schackman, Bruce R
  • Das, Moupali
  • Lindblad, Robert
  • Erickson, Sarah
  • Korthuis, P Todd
  • Martino, Steve
  • Sorensen, James L
  • Szapocznik, José
  • Walensky, Rochelle
  • Branson, Bernard
  • Colfax, Grant N
  • et al.


We examined the effectiveness of risk reduction counseling and the role of on-site HIV testing in drug treatment.


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.


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).


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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