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August 10, 1994

Limited Effects of HIV Counseling and Testing for WomenA Prospective Study of Behavioral and Psychological Consequences

Author Affiliations

From the Department of Internal Medicine, Yale University School of Medicine (Drs Ickovics and Rodin), and the Department of Psychology, Yale University, New Haven, Conn (Drs Ickovics and Rodin and Mss Morrill, Beren, and Walsh).

JAMA. 1994;272(6):443-448. doi:10.1001/jama.1994.03520060043030

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.(JAMA. 1994;272:443-448)