A participant observation study using actors at 30 publicly funded HIV counseling and testing sites in Pennsylvania

Objectives. This study was designed to augment an evaluation of Pennsylvani a publicly funded HIV counseling and testing sites, particularly of the sta ff-client interaction. Methods. Actors were trained as research assistants and sent to 30 randomly chosen sites to be tested and counseled for HIV disease. Instruments based on Centers for Disease Control and Prevention (CDC) guidelines were design ed and used to evaluate them. Results. Data were generated that identified the range of compliance with C DC guidelines and state policy. Among the findings were that 10 of 30 sites required signed consents despite a state policy allowing anonymous testing . Only 17% of providers developed a written risk reduction plan, even thoug h 69% of all sites surveyed by mail asserted that such plans were developed . Only 2 of 5 HIV-positive actors were offered partner notification service s. even though 100% of sites visited by an interviewer claimed to offer suc h services. Conclusions. The findings suggest that although evaluation methods such as mail surveys and site visits are useful for evaluating the existence of app ropriate policies and protocols and gathering baseline data, they might nor he sufficient for assessing actual staff-client interaction.