Limited effects of HIV counseling and testing for women. A prospective study of behavioral and psychological consequences
J. R. Ickovics, A. C. Morrill, S. E. Beren, U. Walsh and J. Rodin
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8025.
OBJECTIVES--To assess the consequences of human immunodeficiency virus
(HIV) counseling and testing for seronegative women in terms of sexual
behavior and psychological outcomes. DESIGN--The design is prospective and
longitudinal, using repeated measures. Participants were interviewed at
recruitment, 2 weeks later (when tested women received results), and 3
months later. SETTING--Four community health clinics in southern
Connecticut; all provide HIV counseling and testing and other specialized
and primary health care services. STUDY PARTICIPANTS--A sequential sample
of women were recruited for two study groups: those seeking HIV counseling
and testing (n = 152), and a comparison group never tested for HIV (n =
78), matched by clinic, race, and age. MAIN OUTCOME MEASURES--A composite
measure of sexual risk was developed, based on sexual activity, condom use,
and partner risk factors. Psychometrically valid and reliable measures of
general psychological functioning and acquired immunodeficiency syndrome
(AIDS)--specific psychological indicators were also used. RESULTS--Average
level of sexual risk was lower for tested than nontested women at all three
interviews. For both groups, there was no significant change in sexual risk
from baseline to 3-month follow-up. At the individual level, there was no
difference in the number of women who decreased or increased sexual risk.
For tested women, intrusive thoughts about AIDS and estimated chance of
getting AIDS decreased after counseling and testing.
CONCLUSIONS--Behavioral and psychological consequences of HIV counseling
and testing for women at risk for HIV were limited. These results have
implications for further prevention interventions.
