title: High rates of HIV testing despite low perceived HIV risk among African-American sexually transmitted disease patients.
abstract: OBJECTIVE
  In the current diagnosis-based, human immunodeficiency virus (HIV) prevention climate, previous testing among persons at elevated HIV risk has cost and efficacy implications, as it signals continued behavioral risk, limited HIV knowledge or overuse of services. This study sought to determine the proportion of African Americans newly seeking sexually transmitted disease (STD) diagnosis who previously had obtained HIV counseling and testing.
  
  
  METHODS
  This was a clinic-based, cross-sectional survey of African-American adults (N=408) seeking STO diagnosis at a public STD clinic located in a high-HIV and STD prevalence city in the U.S. south.
  
  
  RESULTS
  Eighty-four percent of respondents had previously obtained HIV counseling and testing: 68% had previously obtained care at the clinic. Sixty-five percent of respondents perceived themselves as having low or no HIV risk. Seventy-two percent correctly answered > or = 3 of 4 HIV knowledge items.
  
  
  CONCLUSIONS
  Although diagnosis-based HIV prevention initiatives promote HIV counseling and testing for both primary and secondary HIV prevention, these findings suggest that many African-American STD patients remain at risk following testing. Future research should explore how the counseling portion of standard HIV counseling and testing influences subsequent knowledge, attitudes, risk perceptions and behaviors.
authors.affiliation: Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. chandra_ford@med.unc.edu
authors.forename: Chandra L
authors.initials: CL
authors.lastname: Ford
authors.forename: Mark
authors.initials: M
authors.lastname: Daniel
authors.forename: William C
authors.initials: WC
authors.lastname: Miller
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000208:ethnology; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D018570:Risk Assessment; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000208:ethnology; D012938:Social Perception; D011795:Surveys and Questionnaires