Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985-1997.

Abstract

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.

HIV testing experiences of Aboriginal youth in Canada: service implications

“…Despite changes to HIV testing guidelines in some jurisdictions that may encourage less test counseling (Branson et al, 2006), HIV test counseling remains central to testing as it provides an opportunity to promote behavior change and potentially control the spread of HIV (Holtgrave & McGuire, 2007;Norton, Miller, & Johnson, 1997;Weinhardt, Carey, Johnson, & *Corresponding author. Email: cworth@ucalgary.ca Bickham, 1999). It also provides an opportunity to link those who test HIV positive to treatment (Hult, Maurer, & Moskowitz, 2009;Obermeyer & Osborn, 2007).…”

Unsafe Sexual Behavior Among HIV-Infected Patients in Croatia, 2006: Prevalence and Associated Factors

“…Thus, it has become increasingly important to gather information about factors associated with high-risk sexual behavior among persons with HIV infection and to develop interventions to prevent the spread of HIV to their uninfected partners. Several studies have shown that HIV-infected persons who become aware of their infection tend to reduce or at least to temporarily refrain from activities that would cause risk to others (Cleary et al 1991;Higgins et al 1991;Weinhardt et al 1999). Later reports suggest that such behavioral changes are not maintained in a substantial proportion of HIV-infected persons (Crepaz and Marks 2002;Stall et al 2000).…”

Effects of HIV-Prevention Interventions for Samples with Higher and Lower Percents of Latinos and Latin Americans: A Meta-Analysis of Change in Condom Use and Knowledge

“…In the past, several meta-analyses estimated the outcomes of HIV-prevention programs, particularly condom use (Albarracín, Gillette, Glasman, Durantini, & Ho, 2005;Johnson, Carey, Marsh, Levin, & Scott-Sheldon, 2003;Weinhardt, Carey, & Johnson, 1999). For example, Albarracín et al (2005) revealed that HIV-prevention strategies produce small to moderate behavioral effects across the board, whereas Albarracín et al (2003) reported no significant impacts across populations and strategies.…”