AIDS Testing pp 302-319 | Cite as

HIV Counseling and Testing: What Is It and How Well Does It Work?

  • S. Lynda Doll
  • B. Meaghan Kennedy


In 1985 the U.S. government, in collaboration with state and local health departments, established a network of publicly funded human immunodeficiency virus (HIV) counseling and testing programs. By 1991 there were 65 programs in 50 states, 6 cities, 7 territories, the District of Columbia, and Puerto Rico that offered counseling and testing services through facilities such as freestanding counseling and testing centers; sexually transmitted disease (STD), family planning, prenatal, and tuberculosis clinics; drug treatment centers; and prisons. The number of HIV antibody tests provided through these programs has grown steadily from approximately 79,000 in 1985 to 2,090,635 in 1991; most of the tests have been performed at freestanding sites (38%) or STD clinics (27%).


Sexually Transmitted Disease Seropositive Individual Sexually Transmitted Disease Clinic Seronegative Individual Sexually Transmitted Disease Clinic Patient 
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  1. 1.
    Centers for Disease Control and Prevention. Publicly funded HIV counseling and testing—United States, 1991. MMWR 1992;41:613–617Google Scholar
  2. 2.
    Rugg DL, MacGowan RJ, Stark KA, Swanson NM. Evaluating the CDC program for 11IV counseling and testing. Public Health Rep 1991;106:708713Google Scholar
  3. 3.
    Centers for Disease Control and Prevention. Public Health Service guidelines for counseling and antibody testing to prevent HIV infection and AIDS. MMWR 1987;36:509–515Google Scholar
  4. 4.
    Fehrs LJ, Foster LR, Fox V, et al. Public health trial of anonymous versus confidential human immunodeficiency virus testing. Lancet 1988;2:379–382PubMedCrossRefGoogle Scholar
  5. 5.
    Paringer L, Phillips KA, Hu T. Who seeks HIV testing? The impact of risk, knowledge, and state regulatory policy on the testing decision. Inquiry 1991; 28:226–235PubMedGoogle Scholar
  6. 6.
    Myers T, Orr KW, Locker D, Jackson EA. Factors affecting gay and bisexual men’s decisions and intentions to seek HIV testing. Am J Public Health 1993;83:701–704PubMedCrossRefGoogle Scholar
  7. 7.
    Phillips KA. HIV counseling and testing in developing countries: a research agenda. Unpublished manuscript, 1993Google Scholar
  8. 8.
    Centers for Disease Control and Prevention. “Technical guidance on HIV counseling. MMWR 1993;42:11–17Google Scholar
  9. 9.
    Valdiserri RO, Moore M, Gerber AR, et al. A study of clients returning for counseling after HIV testing: implications for improving rates of return. Public Health Rep 1993;108:12–18PubMedGoogle Scholar
  10. 10.
    Miller D. Counselling and psychosocial intervention. In Adler M (ed): ABC of AIDS (2nd ed). London: British Medical Journal, 1990:39–43Google Scholar
  11. 11.
    Celum CL, Coombs RW, Lafferty W, et al. Indeterminate human immunodeficiency virus type 1 Western blots: seroconversion, risk, specificity of supplemental tests, and an algorithm for evaluation. J Infect Dis 1991;164:656–664PubMedCrossRefGoogle Scholar
  12. 12.
    Kleinman S. The significance of HIV-1-indeterminate Western blot results in blood donor populations. Arch Pathol Lab Med 1990;114:298–303PubMedGoogle Scholar
  13. 13.
    Fillipo BH, Russin SJ. What to do when results of a Western blot test are indeterminate. Postgrad Med J 1991;89:39–40Google Scholar
  14. 14.
    Perry SW, Markowitz JC. Counseling for HIV testing. Ilosp Commun Psychiatry 1988;39:731–739Google Scholar
  15. 15.
    Green J. Counseling in HIV Infection and AIDS. Cambridge: Blackwell Scientific, 1989.Google Scholar
  16. 16.
    Weddington WW, Brown BS. Counseling regarding human immunodeficiency virus—antibody testing: an interactional method of knowledge and risk assessment. J Subst Abuse Treat 1989;6:77–82PubMedCrossRefGoogle Scholar
  17. 17.
    Bresolin LB, Rinaldi RC. Human immunodeficiency virus blood test counseling for adolescents. Arch Fam Med 1993;2:673–676PubMedCrossRefGoogle Scholar
  18. 18.
    Janosik EH, Smith C, Hardman MM. Crisis Counseling. [City]: Wadsworth, 1984Google Scholar
  19. 19.
    Grace WC, Genser SG, Coslett RN. Psychotherapeutic principles and AIDS counseling for drug injectors. Focus 1992;7:1—4Google Scholar
  20. 20.
    Silverman D, Perakyla A, Bor R. Discussing safer sex in HIV counseling: assessing three communication formats. AIDS Care 1992;4:69–82PubMedCrossRefGoogle Scholar
  21. 21.
    Prochaska JO, DiClemente CC, Norcross JC. In search of how people change: applications to addictive behaviors. Am Psychol 1992;47:1102–1114PubMedCrossRefGoogle Scholar
  22. 22.
    Coates TJ, Lo B. Counseling patients seropositive for human immunodeficiency virus: an approach for medical practice. West J Med 1990;153:629634Google Scholar
  23. 23.
    Wilson RR (ed). Problem Pregnancy and Abortion Counseling. Saluda, NC: Family Life Publications, 1973Google Scholar
  24. 24.
    Huggins J, Elman N, Baker C, Forrester RG, Lyter D. Affective and behavioral responses of gay and bisexual men to HIV antibody testing. Soc Work 1991;36:61–66PubMedGoogle Scholar
  25. 25.
    Siegel K, Levine MP, Brooks C, Kern R. The motives of gay men for taking or not taking the HIV antibody test. Soc Probl 1989;36:368–383CrossRefGoogle Scholar
  26. 26.
    Macro International. Assessment of CDC-Funded Counseling and Testing, Referral, and Partner Notification (CTRPN) Services for Prevention of HIV Transmission. 1992Google Scholar
  27. 27.
    Centers for Disease Control and Prevention. HIV counseling and testing services—United States, 1992. MMWR 1992;41:749–752Google Scholar
  28. 28.
    Valdiserri RO, Holtgrave DR, Brackbill RM. American adults’ knowledge of 111V testing availability. Am J Public Health 1993;83:525–528PubMedCrossRefGoogle Scholar
  29. 29.
    Hardy AM, Dawson DA. HIV antibody testing among adults in the United States: data from 1988 NHIS. Am J Public Health 1990;80:586–589PubMedCrossRefGoogle Scholar
  30. 30.
    Henry K, Maki M, Willenbring K, Campbell S. The impact of experience with AIDS on 1-11V testing and counseling practices: a study of U.S. infectious disease teaching hospitals and Minnesota hospitals. AIDS Educ Prey 1991;3: 314–321Google Scholar
  31. 31.
    Kegeles SM, Coates TJ, Christopher TA, Lazarus JL. Perceptions of AIDS: the continuing saga of AIDS-related stigma. AIDS 1989;3:253–258CrossRefGoogle Scholar
  32. 32.
    Wolfson MA, Wartenberg AA, Stein MD. AIDS and substance ahuse. Project ADEPT. Providence, RI: Brown University, 1991Google Scholar
  33. 33.
    Cleary P, Van Devanter N, Rogers TF, et al. Depressive symptoms in donors notified of HIV infection. Am J Public Health 1993;83:534–539PubMedCrossRefGoogle Scholar
  34. 34.
    Higgins DL, Galavotti C, O’Reilly KR, et al. Evidence for the effects of HIV antibody counseling and testing on risk behaviors. JAMA 1991;266:2419–2429PubMedCrossRefGoogle Scholar
  35. 35.
    Fox R, Odaka N, Brookmeyer R, Polk BF. Effect of HIV antibody disclosure on subsequent sexual activity in homosexual men. AIDS 1987;1:241–246PubMedGoogle Scholar
  36. 36.
    Moulton JM, Stempel RR, Bacchetti P, Temoshok L, Moss AR. Results of a one year longitudinal study of HIV antibody test notification from the San Francisco General Hospital cohort. J AIDS 1991;4:787–794Google Scholar
  37. 37.
    Ostrow DG, Joseph JG, Kessler R, et al. Disclosure of HIV antibody status: behavioral and mental health correlates. AIDS Educ Prey 1989;1:1–11Google Scholar
  38. 38.
    Adib SM, Joseph JG, Ostrow DG, Tal M, Schwartz SA. Relapse in sexual behavior among homosexual men: a 2-year follow-up from the Chicago MACSICCS. AIDS 1991;5:757–760PubMedCrossRefGoogle Scholar
  39. 39.
    Doll LS, O’Malley PM, Pershing AL, et al. High-risk sexual behavior and knowledge of HIV antibody status in the San Francisco City Clinic cohort. Health Psychol 1990;9:253–265PubMedCrossRefGoogle Scholar
  40. 40.
    Dilley JW, Pies C, Helguist M. Face to Face: A Guide to AIDS Counseling. San Francisco: AIDS Health Project, University of California, 1989Google Scholar
  41. 41.
    Chesney MA. Health psychology in the 21st century: acquired immunodeficiency syndrome as a harbinger of things to come. Health Psychol 1993;12: 259–268PubMedCrossRefGoogle Scholar
  42. 42.
    Lemp GF, Payne SF, Neal D, Temelso T, Rutherford GW. Survival trends for patients with AIDS. JAMA 1990;263:402–406PubMedCrossRefGoogle Scholar
  43. 43.
    Coates TJ, Morin SF, McKusick L. Behavioral consequences of AIDS antibody testing among gay men. JAMA 1987;258:1889PubMedCrossRefGoogle Scholar
  44. 44.
    McCusker J, Stoddard AM, Mayer KH, et al. Effects of HIV antibody test knowledge on subsequent sexual behaviors in a cohort of homosexually active men. Am.1 Public Health 1988;78:462–467CrossRefGoogle Scholar
  45. 45.
    Wiktor SZ, Biggar RJ, Melhye M, et al. Effect of knowledge of human immunodeficiency virus infection status on sexual activity among homosexual men. J AIDS 1990:3:62–68Google Scholar
  46. 46.
    McKusick L, Coates TJ, Morin SF, Pollack L, Hoff C. Longitudinal predictors of reductions in unprotected anal intercourse among gay men in San Francisco: the AIDS behavioral research project. Am J Public Health 1990;80:978–982PubMedCrossRefGoogle Scholar
  47. 47.
    Casadonte PP, Des Jarlais DC, Friedman SR, Rotrosen JP. Psychological and behavioral impact among intravenous drug users of learning HIV test results. Int J Addict 1990;25:409–426PubMedGoogle Scholar
  48. 48.
    Cleary PD, Van Devanter N, Rogers TF, et al. Behavior changes after notification of HIV infection. Am J Public Health 1991;81:1586–1590PubMedCrossRefGoogle Scholar
  49. 49.
    Landis SE, Earp JL, Koch GG. Impact of HIV testing and counseling on subsequent sexual behavior. AIDS Educ Prey 1992;4:61--70Google Scholar
  50. 50.
    Futterman D, Hein K, Kipke M, et al. HIV testing: adolescents. In: Abstracts from the XI International Conference on AIDS, San Francisco, 1990Google Scholar
  51. 51.
    Skurnick J, Bromberg J, Cordell J, et al. Change in couples’ sexual activity after knowledge of HIV discordance: a report from the heterosexual HIV transmission study. In: Abstracts from the XIII International Conference on AIDS, Amsterdam, 1992Google Scholar
  52. 52.
    Otten MW, Zaidi AA, Wroten JE, Witte JJ, Peterman TA. Changes in sexually transmitted disease rates after HIV testing and post-test counseling; Miami, 1988 to 1989. Am J Public Health 1993;83:529–533PubMedCrossRefGoogle Scholar
  53. 53.
    Zenilman JM, Erickson B, Fox R, Reichart CA, Hook EW. Effect of HIV post-test counseling on STD incidence. JAMA 1992;267:843–845PubMedCrossRefGoogle Scholar
  54. 54.
    Sunderland A, Minkoff HL, Handte J, Morose G, Landesman S. The impact of human immunodeficiency virus serostatus on reproductive decisions of women. Obstet Gynecol 1992;79:1027–1031PubMedGoogle Scholar
  55. 55.
    Johnstone FD, Brettle RP, MacCallum LR, et al. Women’s knowledge of their HIV antibody state: its effect on their decision whether to continue the pregnancy. BMJ 1990;300:23–24PubMedCrossRefGoogle Scholar
  56. 56.
    Selwyn PA, Carter RJ, Schoenbaum EE, et al. Knowledge of HIV antibody status and decisions to continue or terminate pregnancy among intravenous drug users. JAMA 1990;261:3567–3571CrossRefGoogle Scholar
  57. 57.
    Ostrow DG, Leite MC, Beltran E, Adib SM. Long term effects of HIV serostatus on mental health and sexual behavior. In: Abstracts from the XIII International Conference on AIDS, Amsterdam, 1992Google Scholar
  58. 58.
    Perry SW, Jacohsberg LB, Fishman B, et al. Psychological responses to serological testing for HIV. AIDS 1990;4:145–152PubMedCrossRefGoogle Scholar
  59. 59.
    Ickovics J, Morill A, Beren S, Walsh U, Rodin J. HIV testing & women: behavioral/psychological consequences. In: Abstracts from the XIII International Conference on AIDS, Amsterdam, 1992Google Scholar
  60. 60.
    Perry S, Jacobson L, Card CAL, et al. Severity of psychiatric symptoms after HIV testing. Am J Psychiatry 1993;150:775–779PubMedGoogle Scholar
  61. 61.
    Antoni MH, Baggett L, Ironson G, et al. Cognitive-behavioral stress management intervention buffers distress responses and immunologic changes following notification of HIV-1 seropositivity. J Consult Clin Psychol 1991;59:906–915CrossRefGoogle Scholar
  62. 62.
    Kelly JA, Murphy DA, Sikemma KJ, Kalichman SC. Psychological intervention to prevent HIV infection are urgently needed: new priorities for behavioral research in the second decade of AIDS. Am Psychol 1993;48:1023—1034PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • S. Lynda Doll
  • B. Meaghan Kennedy

There are no affiliations available

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