title: A randomized control trial evaluating the educational effectiveness of a rapid HIV posttest counseling video.
abstract: OBJECTIVE
  Many of the individuals most at risk for HIV infection (i.e., minority populations, women, adolescents) are also the most marginalized by our health care system. Lacking primary care providers, they rely on the Emergency Department (ED) for their health care needs and education. In this prospective randomized controlled trial, we compared the educational effectiveness of a 15-minute posttest counseling video with the normal practice of a session with an HIV counselor. The study population was composed of ambulatory patients recruited for rapid HIV testing in the ED.
  
  
  METHODS
  The RAs (research assistants) recruited a convenience sample of stable patients presenting to the walk-in section of an inner-city adult ED for rapid HIV testing. Eligible patients for this study included patients who consented for the rapid HIV test and completed measures on condom intention and condom use self-efficacy. Before receiving their results, participants who consented to be in this study were randomized to either a 15-minute HIV posttest educational video available in English/Spanish or to a posttest educational session with an HIV counselor. Afterwards, both groups completed an assessment tool concerning HIV prevention and transmission.
  
  
  RESULTS
  Of the 128 participants, 61 and 67 patients were randomized to the video and counselor groups, respectively. The groups were similar with respect to gender, ethnicity and experience with prior HIV testing. Mean knowledge scores were higher in the video group (76.20% vs. 69.3%; 90% CI for the difference, 2.8, 11.2). As the lower bound of the CI for the difference was higher than the lower equivalence boundary (-5%), we infer that the video was at least as effective as the counselor educational session.
  
  
  CONCLUSIONS
  The use of an educational counseling video is a valid alternative for providing posttest education and prevention information during the waiting period associated with the 20-minute HIV rapid test. Without disruption in clinical flow, both testing and education can be accomplished in a meaningful way in a busy ED.
authors.affiliation: Jacobi Medical Center, Bronx, New York, USA. Yvette.calderon@nbhn.net
authors.forename: Yvette
authors.initials: Y
authors.lastname: Calderon
authors.forename: Jason
authors.initials: J
authors.lastname: Leider
authors.forename: Susan
authors.initials: S
authors.lastname: Hailpern
authors.forename: Marianne
authors.initials: M
authors.lastname: Haughey
authors.forename: Reena
authors.initials: R
authors.lastname: Ghosh
authors.forename: Pamela
authors.initials: P
authors.lastname: Lombardi
authors.forename: Polly
authors.initials: P
authors.lastname: Bijur
authors.forename: Laurie
authors.initials: L
authors.lastname: Bauman
mesh_terms: D015492:AIDS Serodiagnosis; D000328:Adult; D003376:Counseling / Q000379:methods*; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission; D006266:Health Education; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D017064:Process Assessment, Health Care; D013997:Time Factors; D014743:Videotape Recording; D055815:Young Adult