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.

Although many studies have documented an association between interparental conflict (IPC) and child outcomes, the relation of specific dimensions of conflict to the adjustment of offspring remains largely unexplored. The Children's Perceptions of Interparental Conflict Scale (CPIC) was developed by J. H. Grych, M. Seid, and F. D. Fincham (1992) to assess school-aged children's perceptions of several dimensions of IPC. The purpose of the current study was to examine the suitability of the CPIC for use with late adolescents. The factor structure of the CPIC dimensions and indexes of reliability and validity were examined in a sample of 215 participants 17 to 21 years old. The emergent factor structure closely resembled the factor structure found with the younger sample. The CPIC also demonstrated good reliability and external validity.

Qualitative methods have the potential to address important issues in pediatric psychology.

Expanded school mental health (ESMH) programs address the limitations of traditional mental health agencies in meeting the needs of youth by providing a full range of services in a familiar and nonstigmatizing setting. Because of the central role families play in the lives of children, their involvement in ESMH can enhance the effectiveness of treatments and ensure that services are responsive to the needs of the larger community. Increasing family involvement, however, is a complex and resource-intensive endeavor, and requires consideration of the goals of the ESMH program and potential obstacles to meeting those goals. The challenges of involving family members in ESMH, guidelines for determining the program's goals with respect to family involvement, and strategies for achieving these goals are described. Underlying the strategies is the need to be flexible, creative, and respectful of the beliefs and concerns of the families served by the ESMH program.

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