Authors: Metcalf, CA¹; Dillon, B¹; Malotte, CK²; Douglas, JM, Jr.³; Cross, H⁴; and the RESPECT-2 Study Group

¹Centers for Disease Control and Prevention, Atlanta, GA; ²California State University Long Beach, Long Beach, CA; ³Denver Public Health, Denver, CO; ⁴New Jersey Department of Health and Senior Services, Trenton, NJ

Issue: Rapid HIV tests allow clients to be tested and receive their results during a single clinic visit, eliminating the need for a second visit in those whose results are negative.

Setting: Public STD clinics in Long Beach, Denver, and Newark.

Project: RESPECT-2 is an ongoing multi-site randomized controlled trial comparing the efficacy of rapid HIV testing with 2 consecutive counseling sessions in a single visit, and standard HIV testing with 2 counseling sessions 1 to 2 weeks apart. STD clinic clients who consent to participate are randomized to have HIV testing and counseling by one of these 2 methods. HIV-negative participants in both arms are followed for one year with STD screening every 3 months. From November 2000, participants answered a brief survey on HIV testing preferences at the 3-month follow-up visit. In order to preserve blinding, the type of HIV testing and counseling intervention received at enrollment was not considered in analyzing test preferences.

Results: Of the 135 participants who answered the survey, 81% said they would prefer to receive the HIV result the same visit; 5% preferred to wait 1 to 2 weeks, and 13% had no preference. Of the 14 who had been tested for HIV previously but did not know the result of their most recent HIV test prior to enrollment, 13 (93%) said they would prefer to receive the HIV result the same visit. All 6 of the MSM in the survey said they would prefer to receive the HIV result the same visit. Participants who preferred to wait for the HIV result were more likely to consider HIV testing stressful than those who preferred to be given the result the same visit (57% vs. 20%; p<0.05). Of those who preferred to receive the HIV result the same visit, reasons given were: finding it less stressful (58%); getting the result sooner (32%); and not having to have a second clinic visit (21%). Of those who preferred to wait for the HIV result, reasons given were: having more time to prepare for receiving the result (57%); a belief that the test would be more accurate (29%); and finding it less stressful (14%).

Lessons learned: Most clients attending STD clinics prefer to receive their HIV result the same visit. Rapid HIV testing is especially useful in providing counseling and results to clients who are unlikely to return for the test result. However, the efficacy of counseling given in one clinic visit relative to 2 clinic visits is not yet known.