HIV counseling and testing: Women's experiences and the perceived role of testing as a prevention strategy

CONTEXT: It is unclear why women decide to undergo testing for HIV, and how positive and negative test results impact their sexual behavior. METHODS: A sample of 360 family planning clinic clients in New York City were randomly assigned to receive a four-or eight-week intervention aimed at reducing sexual risk or to serve as controls. Information on their HIV testing experiences was gathered through interviews at baseline and one month, six months and one year after the intervention. RESULTS: At baseline, 67% of women had been tested for HIV. The predominant reason for not being tested was anxiety about the result. Regardless of their testing status at baseline, more than 40% of the women believed that getting tested is a good way to prevent acquiring HIV. Women in the intervention who had been tested multiple times or had last been tested more than six months ago were more likely than women in the control group to initiate HIV testing by the one-month follow-up (relative risk, 2.9 and 6.1, respectively). Rates of mutual testing (being tested at the same time as one's partner) were significantly greater among women who participated in an intervention than among controls at the one-month and six-month interviews. CONCLUSIONS: HIV test counseling must emphasize that testing is not a prevention strategy in and of itself. Mutual testing, although not without risks, offers the safest possible alternative for monogamous couples who choose to forgo condoms.