Implementing Rapid HIV Testing With or Without Risk-Reduction Counseling in Drug Treatment Centers: Results of a Randomized Trial

Authors:
  • LGLauren Gooden
    Lauren Gooden
  • TMTim Matheson
    Tim Matheson
  • RMRaul N. Mandler
    Raul N. Mandler
  • LHLouise Haynes
    Louise Haynes
  • STSusan Tross
    Susan Tross
  • TKTiffany Kyle
    Tiffany Kyle
  • DGDianne Gallup
    Dianne Gallup
  • AKAndrzej S. Kosinski
    Andrzej S. Kosinski
  • ADAntoine Douaihy
    Antoine Douaihy
  • BSBruce R. Schackman
    Bruce R. Schackman
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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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