title: Implementing rapid HIV testing with or without risk-reduction counseling in drug treatment centers: results of a randomized trial.
abstract: OBJECTIVE
  We examined the effectiveness of risk reduction counseling and the role of on-site HIV testing in drug treatment.
  
  
  METHODS
  Between January and May 2009, we randomized 1281 HIV-negative (or status unknown) adults who reported no past-year HIV testing to (1) referral for off-site HIV testing, (2) HIV risk-reduction counseling with on-site rapid HIV testing, or (3) verbal information about testing only with on-site rapid HIV testing.
  
  
  RESULTS
  We defined 2 primary self-reported outcomes a priori: receipt of HIV test results and unprotected anal or vaginal intercourse episodes at 6-month follow-up. The combined on-site rapid testing participants received more HIV test results than off-site testing referral participants (P<.001; Mantel-Haenszel risk ratio=4.52; 97.5% confidence interval [CI]=3.57, 5.72). At 6 months, there were no significant differences in unprotected intercourse episodes between the combined on-site testing arms and the referral arm (P=.39; incidence rate ratio [IRR]=1.04; 97.5% CI=0.95, 1.14) or the 2 on-site testing arms (P=.81; IRR=1.03; 97.5% CI=0.84, 1.26).
  
  
  CONCLUSIONS
  This study demonstrated on-site rapid HIV testing's value in drug treatment centers and found no additional benefit from HIV sexual risk-reduction counseling.
authors.affiliation: Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, Miami, FL 33136, USA. Lmetsch@med.miami.edu
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Metsch
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Feaster
authors.forename: Lauren
authors.initials: L
authors.lastname: Gooden
authors.forename: Tim
authors.initials: T
authors.lastname: Matheson
authors.forename: Raul N
authors.initials: RN
authors.lastname: Mandler
authors.forename: Louise
authors.initials: L
authors.lastname: Haynes
authors.forename: Susan
authors.initials: S
authors.lastname: Tross
authors.forename: Tiffany
authors.initials: T
authors.lastname: Kyle
authors.forename: Dianne
authors.initials: D
authors.lastname: Gallup
authors.forename: Andrzej S
authors.initials: AS
authors.lastname: Kosinski
authors.forename: Antoine
authors.initials: A
authors.lastname: Douaihy
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Schackman
authors.forename: Moupali
authors.initials: M
authors.lastname: Das
authors.forename: Robert
authors.initials: R
authors.lastname: Lindblad
authors.forename: Sarah
authors.initials: S
authors.lastname: Erickson
authors.forename: P Todd
authors.initials: PT
authors.lastname: Korthuis
authors.forename: Steve
authors.initials: S
authors.lastname: Martino
authors.forename: James L
authors.initials: JL
authors.lastname: Sorensen
authors.forename: José
authors.initials: J
authors.lastname: Szapocznik
authors.forename: Rochelle
authors.initials: R
authors.lastname: Walensky
authors.forename: Bernard
authors.initials: B
authors.lastname: Branson
authors.forename: Grant N
authors.initials: GN
authors.lastname: Colfax
mesh_terms: D000328:Adult; D003376:Counseling / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006678:HIV; D015658:HIV Infections / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015397:Program Evaluation; D040242:Risk Reduction Behavior; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data*; D014481:United States; D047568:Unsafe Sex / Q000706:statistics & numerical data