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Evidence summaries

Effects of HIV Counseling and Testing on Sexual Risk Behaviour

HIV-positive participants and HIV-serodiscordant couples decrease their risk behaviour after HIV counseling and testing. However, participants who receive a negative HIV test result do not modify their behaviour. Level of evidence: "A"

A systematic review 1 including 27 studies with a total of 19,597 subjects was abstracted in DARE. The number of sexual partners decreases (mean effect size 0.34, 95% CI 0.20 to 0.47), the number of unprotected intercourse decreased (mean effect size 0.47, 95% CI 0.32 to 0.61 for the HIV positive group, and 0.75, 95% CI 0.59 to 0.92 for the serodiscordant couples). The HIV negative participants did not reduce their frequency of intercourse relative to untested participants. For condom use the mean effect size for HIV-positive group was 0.65, 95% CI 0.42 to 0.87) and for the serodiscordant couples 1.31, 95% CI 1.14 to 1.48). The HIV-negative participants did not increase their condom use more than untested participants. The incidence of sexually transmitted diseases decreased in HIV-positive participants (effect size 0.15, 95% CI 0.04 to 0.26), but increased in HIV-negative participants (effect size = -0.17, 95% CI -0.27 to -0.06) and among untested participants (-0.05, 95% CI -0.09 to -0.01).

    References

    • Weinhardt LS, Carey MP, Johnson BT, Bickham NL. Effects of HIV counseling and testing on sexual risk behavior: a meta-analytic review of published research, 1985-1997. Am J Public Health 1999 Sep;89(9):1397-405. [PubMed] [DARE]

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