Limited effects of HIV counseling and testing for women. A prospective study of behavioral and psychological consequences.

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.