Journal of Community Health

, Volume 21, Issue 1, pp 11–22 | Cite as

Community-wide HIV counselling and testing in central Massachusetts: Who is retested and does their behavior change?

  • Jane McCusker
  • Georgianna Willis
  • Margaret McDonald
  • Susan M. Sereti
  • Benjamin F. Lewis
  • John L. Sullivan


HIV counselling and testing was provided to 4267 individuals between September 1987 and June 1992 at a multi-site program, including community clinics, drug treatment programs, and a men's prison in central Massachusetts. Half of those tested reported the risk behaviors targeted by the programs: injection drug use (38.1%) and sexual contact with a drug injector (12.6%). The objectives of this study were to examine 1) factors associated with repeat HIV testing among these initially seronegative, and 2) behavior change following counselling and testing. Initially 7.4% were HIV positive, and 12.4% of those testing negative were retested within one year. Risk behavior was the only strong independent predictor of retesting (odds ratios of 3.8 and 4.2 for men reporting sex with men and recent drug injectors, respectively). Changes in risk behaviors between the time of the initial test and the second test were assessed (n = 207). Among those who continued to inject drugs at follow-up there was a reduction in the percent visiting shooting galleries (p = 0.05); no other significant behavior changes were reported. While selection bias may be responsible in part for the minimal behavior change observed, continued monitoring of risk behavior and counselling are warranted.


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Copyright information

© Human Sciences Press, Inc 1996

Authors and Affiliations

  • Jane McCusker
    • 1
    • 2
  • Georgianna Willis
    • 3
  • Margaret McDonald
    • 4
  • Susan M. Sereti
    • 5
  • Benjamin F. Lewis
    • 6
    • 7
  • John L. Sullivan
    • 8
  1. 1.Department of Clinical Epidemiology and Community StudiesSt. Mary's Hospital CentreCanada
  2. 2.Department of Epidemiology and BiostatisticsMcGill UniversityMontrealCanada
  3. 3.Health Policy Research and Development UnitMassachusetts General HospitalBostonUSA
  4. 4.University of Massachusetts at AmherstUSA
  5. 5.Department of Public HealthHIV Counselling, Testing, and Support ServiceWorcesterUSA
  6. 6.School of Public HealthUniversity of Massachusetts at AmherstSalemUSA
  7. 7.Research Centre on Addiction BehaviorSalemUSA
  8. 8.Medical School of the University of Massachusetts Medical CenterWorcesterUSA

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