Abstract text: Annually, 2.6 million persons receive federally funded HIV counseling and testing. A randomized trial, in which patients from five STD clinics were assigned to counseling or education followed by STD testing at 6 and 12 months, found 20% fewer participants assigned to brief risk-reduction counseling acquired STDs compared with participants assigned to usual educational messages. Given counseling cost, varying STD prevalence, and potentially varying intervention efficacy among different persons, we sought to identify which sub-groups benefit most. We conducted a secondary analysis of the trial, using an intent-to treat approach and calculated STD incidence to determine cases prevented among selected subgroups. Of 2,890 participants, 504 (17.4%) were adolescents (<20years); 1708 (59%) were black; 785 (27%) had STD at baseline; 851 (29%) had no prior HIV test; and 1100 (38%) had ever used condoms. After 12 months, new STDs had occurred in 211 (14.6%) of 1443 participants in education compared with 173 (12.0%) of 1447 in counseling. Thus, counseling prevented 2.6 infections per 100 persons counseled overall. Counseling surpassed education in all subgroups but infections prevented per 100 persons counseled was higher in persons: <20 years (9.1) vs. older (1.3); with STD (5.3) vs. without STD (2.1); with condom experience (3.7) vs. no experience (1.4); without prior HIV testing (3.5) vs. with testing (2.3); who were black (3.3) vs. non-blacks (1.2). The greatest benefit per person counseled occurred among adolescents and persons with an STD. Programs with limited funds for counseling should consider giving priority to these persons.
Learning Objectives: At the conclusion of the session, participants will be able to: 1) Recognize the efficacy of risk reduction counseling over usual educational messages among different subgroups attending STD clinics. 2) Identify which subgroups of patient benefit the most from HIV counseling and testing. 3) Determine which subgroups of patients to target for counseling where program funds are limited.
Keywords: Counseling,
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.