April 2003

IDS: Acquired immunodeficiency syndrome. AIDS can affect the immune and central nervous systems and can result in neurological problems, infections, or cancers. It is caused by human immunodeficiency virus (HIV).

Anonymous: In anonymous testing, client identifying information is not linked to testing information, including the request for tests or test results.

Antiretroviral therapy: Treatment with drugs designed to prevent HIV from replicating in HIV-infected persons. Highly active antiretroviral therapy (HAART) is an antiretroviral regimen that includes multiple classifications of antiretroviral drugs.

Capacity building: Activities that strengthen the core competencies of an organization and contribute to its ability to develop and implement an effective HIV prevention intervention and sustain the infrastructure and resource base necessary to support and maintain the intervention.

Client-centered HIV prevention counseling: An interactive risk-reduction counseling model usually conducted with HIV testing, in which the counselor helps the client identify and acknowledge personal HIV risk behaviors and commit to a single, achievable behavior change step that could reduce the client's HIV risk.

Collaboration: Working with another person, organization, or group for mutual benefit by exchanging information, sharing resources, or enhancing the other’s capacity, often to achieve a common goal or purpose.

Community Planning Group: The official HIV prevention planning body that follows the HIV Prevention Community Planning Guidance to develop a comprehensive HIV prevention plan for a project area.

Confidentiality: Pertains to the disclosure of personal information in a relationship of trust and with the expectation that it will not be divulged to others in ways that are inconsistent with the original disclosure. Confidentiality must be maintained for persons who are recommended and/or who receive HIV counseling, testing, and referral (CTR) services.

Confidential HIV test: An HIV test for which a record of the test and the test results are recorded in the client's chart.

Confirmatory test: A highly specific test designed to confirm the results of an earlier (screening) test. For HIV testing, a Western blot or, less commonly, an immunofluorescence assay (IFA) is used as a confirmatory test.

Culturally Appropriate: Conforming to a culture’s acceptable expressions and standards of behavior and thoughts. Interventions and educational materials are more likely to be culturally appropriate when representatives of the intended target audience are involved in planning, developing, and pilot testing them.

Demographics: The statistical characteristics of human populations such as age, race, ethnicity, sex, and size.

Duty to Warn: A legal concept indicating that a health care provider who learns that an HIV-infected client is likely to transmit the virus to another identifiable person must take steps to warn that person; state laws determine what actually constitutes a "duty to warn."

EIA: Enzyme immunoassay. Sometimes referred to as ELISA (see next definition). A commonly used screening test to detect antibodies to HIV.

ELISA: Enzyme-linked immunosorbent assay. A type of EIA (see previous definition). A commonly used screening test to detect antibodies to HIV.

Evaluation: A process for determining how well health systems, either public or private, deliver or improve services and for demonstrating the results of resource investments.

Evidence-based: Behavioral, social, and structural interventions that are relevant to HIV risk reduction, have been tested using a methodologically rigorous design, and have been shown to be effective in a research setting. These evidence- or science-based interventions have been evaluated using behavioral or health outcomes; have been compared to a control/comparison group(s) (or pre-post data without a comparison group if a policy study); had no apparent bias when assigning persons to intervention or control groups or were adjusted for any apparent assignment bias; and, produced significantly greater positive results when compared to the control/comparison group(s), while not producing negative results.

Freestanding HIV test site: A site that provides only HIV services. Sometimes referred to as alternate test site or anonymous test site. Change term use definition.

Group-level interventions: Health education and risk-reduction counseling that shifts the delivery of service from the individual to groups of varying sizes. Group-level interventions use peer and non-peer models involving a range of skills, information, education, and support.

Guidance: Information to assist in efforts to conduct HIV prevention activities; guiding principles.

Guidelines: A dictated set of activities; policies.

HIV: Human immunodeficiency virus, which causes AIDS. Several types of HIV exist, with HIV-1 being the most common in the United States.

HIV test: More correctly referred to as an HIV antibody test, the HIV test is a laboratory procedure that detects antibodies to HIV, rather than the virus itself.

HIV prevention counseling: An interactive process between client and counselor aimed at reducing risky sex and needle-sharing behaviors related to HIV acquisition (for HIV-uninfected clients) or transmission (for HIV-infected clients). See also client-centered HIV prevention counseling.

Incidence: In epidemiology, the number of new cases of infection or disease that occur in a defined population within a specified time.

Individual-level interventions: Health education and risk-reduction counseling provided for one individual at a time. ILIs help clients make plans for behavior change and ongoing appraisals of their own behavior and include skills-building activities. These interventions also facilitate linkages to services in both clinic and community settings (for example, substance abuse treatment settings) in support of behaviors and practices that prevent transmission of HIV, and help clients make plans to obtain these services.

Informed consent: The legally effective permission of a client or legally authorized representative (e.g., parent or legal guardian of a minor child) to undergo a medical test or procedure.

Injection drug user: Someone who uses a needle to inject drugs into his or her body.

Jurisdiction: An area or region that is the responsibility of a particular governmental agency. This term usually refers to an area where a state or local health department monitors HIV prevention activities. (For example, Jonestown is within the jurisdiction of the Jones County Health Department.)

Oral fluid test: A test using oral mucosal transudate, a serous fluid. To differentiate this fluid from saliva, an absorbent material is left in the mouth for several minutes. In an HIV-infected person, oral mucosal transudate is likely to contain HIV antibodies.

Outcome Monitoring: Efforts to track the progress of clients or a program based upon outcome measures set forth in program goals. These measurements assess the effects of interventions on client outcomes such as knowledge, attitudes, beliefs, and behavior. Monitoring allows the identification of changes that occurred, but the intervention may not have been responsible for the change. This would take a more rigorous approach (see Outcome evaluation).

Outcome evaluation: Outcome evaluation involves the assessment of the immediate or direct effects of a program on the program participants; for example, the degree to which the program increased knowledge of HIV/AIDS, perceived risk of infection, and/or decreased intent of engaging in risk behaviors related to HIV transmission. Outcome evaluation also assesses the extent to which a program attains its objectives related to intended short- and long-term change for a target population.

Partner counseling and referral services (PCRS): A prevention activity that aims to a) provide services to HIV-infected persons and their sex and needle-sharing partners so they can reduce their risk for infection or, if already infected, can prevent transmission to others and b) help partners gain earlier access to individualized counseling, HIV testing, medical evaluation, treatment, and other prevention and support services.

Perinatal HIV transmission: Transmission of HIV from the mother to the fetus or infant during pregnancy, delivery, or breast-feeding.

Positive test: For HIV, a specimen sample that is reactive on an initial ELISA test, repeatedly reactive on a second ELISA run on the same specimen, and confirmed positive on Western blot or other supplemental test indicates that the client is infected.

Preliminary Positive: For HIV, a specimen that is reactive on an initial EIA or rapid test. A preliminary HIV positive test result must be confirmed by a reactive test result using Western blot or another supplemental test indicating that the client is infected.

Prevalence: The number or percentage of persons in a given population with a disease or condition at a given point in time.

Prevention case management (PCM): A client-centered HIV prevention activity that promotes adoption of HIV risk-reduction behaviors by clients with multiple, complex problems and risk-reduction needs. PCM is a hybrid of HIV prevention counseling and traditional case management that provides intensive, on-going, individualized prevention counseling, support, and referral to other needed services.

Prevention counseling: An interactive process between client and counselor aimed at reducing risky sex and needle-sharing behaviors related to HIV acquisition (for HIV uninfected clients) or transmission (for HIV-infected clients). See also client-centered HIV prevention counseling and HIV prevention counseling.

Quality assurance: An ongoing process for ensuring that the CTR program effectively delivers a consistently high level of service to the clients.

Rapid HIV test: A test to detect antibodies to HIV that can be collected and processed within a short interval of time (e.g., approximately 10-60 minutes).

Referral: The process through which a client is connected with services to address prevention needs (medical, prevention, and psychosocial support). There are four types of referral: Provider Referral: The provider informs the partner and refers him or her to counseling, testing, and other support services; Patient or Client Referral: The HIV-infected client takes full responsibility to inform his or her partners of their possible exposure to HIV and refers them to counseling, testing, and other support services; Contract Referral: If the HIV-infected client is unable to inform a partner within an agreed-upon time (e.g., 3 days), the provider has the permission and information necessary to do so; Dual Referral: The HIV-infected client and the provider inform the partner(s) together.

Risk assessment: Risk assessment is a fundamental part of a client-centered HIV prevention counseling session in which the client is encouraged to identify, acknowledge, and discuss in detail his or her personal risk for acquiring or transmitting HIV.

Risk factor or behavior: Behavior or other factor that places a person at risk for disease. For example, drug use is a factor that increases risk of acquiring HIV infection; and factors such as sharing injection drug use equipment, unprotected anal or vaginal sexual contact, and commercial unprotected sex increase the risk of acquiring and transmitting HIV.

Risk screening: A brief evaluation of HIV risk factors, both behavioral and clinical, used for decisions about who should be recommended HIV counseling and testing. Risk screening is different from risk assessment.

Screening: Performing a test for all persons in a defined population, is a basic, effective public health tool used to identify an unrecognized condition so that treatment can be offered before symptoms develop.

Sensitivity: The probability that a test will be positive when infection or condition is present.

Seroconversion: Initial development of detectable antibodies specific to a particular antigen; the change of a serologic test result from negative to positive as a result of antibodies induced by the introduction of antigens or microorganisms into the host.

Specificity: The probability that a test will be negative when the infection or condition is not present.

Testing: Performing a test because of a person’s clinical symptoms or behavioral risk factors, has been the predominant paradigm for diagnosing HIV.

Voluntary HIV testing: HIV testing that is offered free of coercion. With voluntary HIV testing, participants have the opportunity to accept or refuse HIV testing.

Western blot: A laboratory test that detects specific antibodies to components of a virus. Chiefly used as a confirmatory test following repeatedly reactive EIA tests or rapid tests.