USEFULNESS OF HUMAN-IMMUNODEFICIENCY-VIRUS POSTTEST COUNSELING BY TELEPHONE FOR LOW-RISK CLIENTS OF AN URBAN SEXUALLY-TRANSMITTED DISEASES CLINIC

Background: Failure of clients to return for post-test counseling for human immunodeficiency virus (HIV) has been noted consistently as a pr oblem with HIV counseling and testing in sexually transmitted diseases clinics. Goals: To assess trends in the rates of HIV post-test counse ling in an urban sexually transmitted diseases clinic, To determine th e usefulness of providing post-test counseling by telephone to clients at low risk for HIV as a means of increasing post-test counseling rat es and efficiency of clinic operations. Study Design and Methods: Huma n immunodeficiency virus post-test counseling rates were evaluated amo ng clients of a sexually transmitted diseases clinic from January 1990 through May 1994, Low-risk clients (n = 1,304) from July 1994 through September 1994 were given the option of obtaining negative HIV test r esults by telephone, Rates of post-test counseling within 45 days were compared with historical controls from March 1994 through May 1994, d uring which time a return visit was required. Results: The rate of pos t-test counseling increased significantly from 1990 to 1992 but remain ed stable thereafter, After the introduction of post-test counseling b y telephone, 704 of 1,304 low-risk clients (54.0%) obtained post-test counseling compared with 476 of 1,187 (40.1%) clients during the contr ol period (odds ratio = 1.75; 95% confidence interval = 1.50-2.06). Po st-test counseling rates increased especially among clients younger th an 20 years of age (30.6% versus 52.7%) and among those with multiple new sex partners in the last month (31.6% versus 56.1%). Conclusions: Telephone post-test counseling is an effective method of increasing ac cess for low-risk clients attending sexually transmitted diseases clin ics and may be especially useful for those who are otherwise unlikely to obtain post-test counseling.