Abstract
Previous research demonstrates that standard voluntary counseling and testing (VCT) in bathhouses is feasible, and is an effective means for identifying new HIV cases and producing short term change in risk and precautionary behaviors. Less is known about whether the promise shown in standard VCT will be maintained as rapid testing is disseminated into outreach settings such as bathhouses. This study aimed to compare the risk and demographic profiles of men presenting for rapid vs. standard VCT in a bathhouse setting, and to explore the effectiveness of rapid VCT in identifying new infections and changing risk and precautionary behaviors. Bathhouse-based VCT was conducted over the course of two years—in the first year, 492 men participated in standard testing, and in the following year 528 men from the same venue participated in rapid testing. Similar percentages of men were found to be positive using rapid and standard testing (2.5% and 3.7%, respectively), although rapid testing delivered results to more individuals than standard testing (97% vs. 71%). Convenience samples of 133 of the standard testers and 161 of the rapid testers were obtained and assessed at two points: immediately prior to and 3 months after testing. The risk and demographic profiles of men participating in standard vs. rapid testing were similar, suggesting that rapid testing is as feasible an approach as standard testing for attracting men with recent histories of HIV-related risk behavior. In the 3 months following rapid VCT, some risk and precautionary behaviors were changed compared to pre-VCT, but effects were smaller than in the previous study of standard VCT.
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Notes
Given the nature of the setting, it is unlikely that men in our sample were in monogamous relationships. However, we ran analyses both including and excluding UAI that occurred with primary partners, for men who reported no UAI with any other partner. Eliminating these acts of UAI that might have occurred in the context of “negotiated safety” did not alter the substantive findings reported.
Given the possibility that effects could differ, depending on whether men in the standard testing condition returned for their results (i.e., depending on whether they received the “full” counseling protocol), we explored whether the effects of the intervention changed if we analyzed only men who obtained results. Additionally, because receiving a positive result might produce greater change, we also examined whether results would differ if we analyzed only the subset of men who tested negative. In neither case were the results substantively different from those presented in Table 4.
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Acknowledgements
We want to acknowledge Steamworks, the collaborating venue in this research, along with the club’s owners, the general manager, and staff, without whom conducting the program and evaluation would have been impossible. We would like to thank the club customers as well, especially those who took the time to participate in the program and evaluation. We also wish to recognize the efforts and support of several people at the local health department: the AIDS Director, LeRoy Blea, the coordinator of HIV testing, Amity Balbutin-Burnham, and the testing program manager at the club, Librado Nunez, as well as his outreach testing team: Tom Tseng, Greg Melhauf, Patrick Borch, Mike Tachet, Jose Luis Tello, Rafael Rodriguez, Megel McCoy. The original evaluation of the standard testing procedures were completed with assistance from Bob Siedle-Khan, Charles Pearson, Thomas Riess, Sherry Fung, Karen Vernon, Moher Downing, and Beth Freedman. Data collection for the rapid testing evaluation was conducted with the assistance of Bob Siedle-Khan, Paul Cotten, Jason Euren, and Kevin Kelley. The procedures for involvement of human participants and their informed consent were reviewed and approved by the Committee for Human Research, University of California San Francisco. The Universitywide AIDS Research Program High Risk Initiative (CR03-SF-520; and PE00-SF-144) funded the UCSF Center for AIDS Prevention Studies to conduct the evaluation.
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Huebner, D.M., Binson, D., Dilworth, S.E. et al. Rapid vs. Standard HIV Testing in Bathhouses: What is Gained and Lost?. AIDS Behav 14, 688–696 (2010). https://doi.org/10.1007/s10461-008-9442-9
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DOI: https://doi.org/10.1007/s10461-008-9442-9