Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985-1997. Am J Public Health 1999 Sep;89(9):1397-405
Date
09/04/1999Pubmed ID
10474559Pubmed Central ID
PMC1508752DOI
10.2105/ajph.89.9.1397Scopus ID
2-s2.0-0032775012 (requires institutional sign-in at Scopus site) 638 CitationsAbstract
OBJECTIVES: This study examined whether HIV counseling and testing leads to reductions in sexual risk behavior.
METHODS: The meta-analysis included 27 published studies that provided sexual behavior outcome data, assessed behavior before and after counseling and testing, and provided details sufficient for the calculation of effect sizes. The studies involved 19,597 participants.
RESULTS: After counseling and testing, HIV-positive participants and HIV-serodiscordant couples reduced unprotected intercourse and increased condom use more than HIV-negative and untested participants. HIV-negative participants did not modify their behavior more than untested participants. Participants' age, volition for testing, and injection drug use treatment status, as well as the sample seroprevalence and length of the follow-up, explained the variance in results.
CONCLUSIONS: HIV counseling and testing appears to provide an effective means of secondary prevention for HIV-positive individuals but, as conducted in the reviewed studies, is not an effective primary prevention strategy for uninfected participants. Theory-driven research with attention given to the context of testing is needed to further explicate the determinants of behavior change resulting from HIV counseling and testing, and the effectiveness of specific counseling approaches.
Author List
Weinhardt LS, Carey MP, Johnson BT, Bickham NLAuthor
Lance S. Weinhardt MS,PhD Associate Dean for Research and Professor of Community and Behavioral Health Promotion in the Joseph. J. Zilber School of Public Health department at University of Wisconsin - MilwaukeeMESH terms used to index this publication - Major topics in bold
AIDS SerodiagnosisAdult
Age Factors
Condoms
Counseling
Female
HIV Infections
HIV Seronegativity
HIV Seropositivity
HIV Seroprevalence
Health Knowledge, Attitudes, Practice
Humans
Male
Primary Prevention
Program Evaluation
Risk-Taking
Sexual Behavior
Substance Abuse, Intravenous
Treatment Outcome