Changes in sexually transmitted disease rates after HIV testing and posttest counseling, Miami, 1988 to 1989.

Abstract

OBJECTIVES. The effects of posttest counseling on acquisition of sexually transmitted diseases in patients at a large urban sexually transmitted disease clinic were studied. METHODS. Comparisons were made of the percentage of patients who had a positive gonorrhea culture (or any sexually transmitted disease) in the 6 months before and after human immunodeficiency virus (HIV) counseling and testing. RESULTS. For 331 patients counseled about a positive HIV test, the percentage with gonorrhea was 6.3 before and 4.5 after posttest counseling (29% decrease). For 666 patients counseled about a negative test, the percentage with gonorrhea was 2.4 before and 5.0 after posttest counseling (106% increase). With any sexually transmitted disease as the outcome, patients who tested positive for HIV had a 12% decrease and patients who tested negative had a 103% increase after counseling. CONCLUSIONS. HIV counseling and testing was associated with a moderate decrease in sexually transmitted diseases among patients who tested positive for the virus, but risk increased for patients who tested negative. This suggests a need to improve posttest counseling in this clinic and to assess the effects of counseling and testing in other clinics.

Ongoing Risk Behavior Among Persons With HIV in Medical Care

“…Beginning in the late 1980s and early 1990s, studies conducted in sexually transmitted disease (STD) clinics began to draw attention to ongoing high risk sexual behavior and high rates of STDs among persons known to be HIV infected (Golden et al, 1996;Lee, Branan, Hoff, Datwyler, & Bayer, 1990;Osewe, Peterman, Ransom, Zaidi, & Wroten, 1996;Otten, Zaidi, Wroten, Witte, & Peterman, 1993;Zenilman, Erickson, Fox, Reichart, & Hook, 1992). More recently, the US Centers for Disease Control and Prevention (CDC) has emphasized the importance of integrating HIV prevention measures into routine HIV care (CDC, 2003;.…”

Réflexion sur les possibilités et les limites de la prévention du VIH auprès des hommes ayant des relations sexuelles avec d’autres hommes dans les sociétés différenciées

“…La promotion de condoms plus épais afin de réduire les risques de bris irait de pair avec une utilisation moindre de lubrifiant, de sorte que le taux de bris -et de risque -resterait similaire (Golombok, Harding et Sheldon, 2001). Le recours fréquent aux tests de dépistage augmenterait le sentiment de sécurité des participants et, corrélati-vement, la prise de risques (Otten et al, 1993). Dans ces exemples, l'adoption de consignes préventives s'accompagne paradoxalement de décisions favorisant un relâchement d'autres mesures également importantes dans la réduction des risques d'infection.…”

Effective Detection of HIV

“…Third, a protocol for publicly funded HIV counseling and testing in the United States has been broadly implemented (9,10). Fourth, HIV counseling and testing appear to be effective intervention strategies for seropositive persons (11)(12)(13)(14)(15)(16)(17)(18). Many persons who are aware of being HIV-seropositive reduce their risk acts substantially compared with those who test HIV-seronegative (18); fewer than 50% (typically only one third) of seropositive persons continue to engage in risk acts (16,(19)(20)(21).…”