Improving HIV Rapid Testing Rates Among STD Clinic Patients: A Randomized Controlled Trial

Objective: The Centers for Disease Control and Prevention recommends that HIV testing be a standard part of medical care; however, testing is voluntary and some patients decline. We evaluated 2 brief interventions to promote rapid HIV testing among STD clinic patients who initially declined testing. Method: Using a randomized controlled trial, patients either viewed an educational digital video disc (DVD) or participated in stage-based behavioral counseling (SBC) provided by a nurse. Sixty clients presenting for care at a STD clinic who initially declined HIV testing at registration and during risk behavior screening participated in the study. Results: The primary outcome was whether patients agreed to be tested for HIV. The secondary outcomes included attitudes, knowledge, and stage-of-change regarding HIV testing. Patients receiving both interventions improved their attitudes and knowledge about testing (ps < .01). Patients receiving SBC agreed to testing more often (45%) than did patients who viewed the DVD (19%; p < .05). Conclusions: Brief interventions can increase rapid HIV testing acceptance among patients who are reluctant to be tested; counseling guided by behavioral science theory is more effective than a well-designed information-based intervention.