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

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Abstract

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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Authors and Affiliations

  1. Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital Centre, Canada

    Jane McCusker MD, DrPH (Head, Professor)

  2. Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada

    Jane McCusker MD, DrPH (Head, Professor)

  3. Health Policy Research and Development Unit, Massachusetts General Hospital, Boston, Massachusetts, USA

    Georgianna Willis PhD (Associate Research Scientist)

  4. University of Massachusetts at Amherst, USA

    Margaret McDonald MA (PhD candidate)

  5. Department of Public Health, HIV Counselling, Testing, and Support Service, Worcester, Massachusetts, USA

    Susan M. Sereti RN, BSN (Coordinator)

  6. School of Public Health, University of Massachusetts at Amherst, Salem, Massachusetts, USA

    Benjamin F. Lewis EdD (Senior Research Fellow, Director)

  7. Research Centre on Addiction Behavior, Salem, Massachusetts, USA

    Benjamin F. Lewis EdD (Senior Research Fellow, Director)

  8. Medical School of the University of Massachusetts Medical Center, Worcester, Massachusetts, USA

    John L. Sullivan MD (Professor of Pediatrics)

Authors
  1. Jane McCusker MD, DrPH
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  2. Georgianna Willis PhD
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  3. Margaret McDonald MA
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  4. Susan M. Sereti RN, BSN
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  5. Benjamin F. Lewis EdD
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  6. John L. Sullivan MD
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Additional information

This work was supported by the National Institute on Drug Abuse, R01-DA05615 and by grants from the Commonwealth of Massachusetts, Division of Public Health.

This work was presented in part at the IX International Conference on AIDS/IV STD World Congress, Berlin, Germany, June 6–11, 1993.

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McCusker, J., Willis, G., McDonald, M. et al. Community-wide HIV counselling and testing in central Massachusetts: Who is retested and does their behavior change?. J Community Health 21, 11–22 (1996). https://doi.org/10.1007/BF01682760

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  • DOI: https://doi.org/10.1007/BF01682760

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