title: Usefulness of human immunodeficiency virus post-test counseling by telephone for low-risk clients of an urban sexually transmitted diseases clinic.
abstract: BACKGROUND
  Failure of clients to return for post-test counseling for human immunodeficiency virus (HIV) has been noted consistently as a problem with HIV counseling and testing in sexually transmitted disease clinics.
  
  
  OBJECTIVE
  To assess trends in the rates of HIV post-test counseling in an urban sexually transmitted disease clinic. To determine the usefulness of providing post-test counseling by telephone to clients at low risk for HIV as a means of increasing post-test counseling rates and efficiency of clinic operations.
  
  
  METHODS
  Human immunodeficiency virus post-test counseling rates were evaluated among clients of a sexually transmitted disease 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 results by telephone. Rates of post-test counseling within 45 days were compared with historical controls from March 1994 through May 1994, during which time a return visit was required.
  
  
  RESULTS
  The rate of post-test counseling increased significantly from 1990 to 1992 but remained stable thereafter. After the introduction of post-test counseling by 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 control period (odds ratio = 1.75; 95% confidence interval = 1.50-2.06). Post-test counseling rates increased especially among clients younger than 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 access for low-risk clients attending sexually transmitted diseases clinics and may be especially useful for those who are otherwise unlikely to obtain post-test counseling.
authors.affiliation: Denver Department of Public Health, University of Colorado Health Sciences Center 80204, USA.
authors.forename: W W
authors.initials: WW
authors.lastname: Schluter
authors.forename: F N
authors.initials: FN
authors.lastname: Judson
authors.forename: A E
authors.initials: AE
authors.lastname: Baro'n
authors.forename: W L
authors.initials: WL
authors.lastname: McGill
authors.forename: W M
authors.initials: WM
authors.lastname: Marine
authors.forename: J M
authors.initials: JM
authors.lastname: Douglas
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D015277:Hotlines; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000706:statistics & numerical data / Q000639:trends*; D012307:Risk Factors; D012749:Sexually Transmitted Diseases; D014504:Urban Health