title: Time devoted to pre- and post-HIV test counselling in different health services according to participants of a rapid testing program in Madrid, Spain.
abstract: BACKGROUND
  The role of pre- and post-test counselling in new HIV testing strategies to reduce delayed diagnosis has been debated. Data on time devoted to counselling are scarce. One approach to this problem is to explore patients' views on the time devoted to counselling by venue of their last HIV test.
  
  
  METHODS
  We analysed data from 1568 people with a previous HIV test who attended a mobile HIV testing program in Madrid between May and December 2008.
  
  
  RESULTS
  The majority (71%) were men (48% had had sex with other men), 51% were <30 years, 40% were foreigners, 56% had a university degree, and 40% had the most recent HIV test within the last year. As regards pre-test counselling, 30% stated they were told only that they would receive the test; 26.3% reported <10 min; 20.4% about 10 min; and 24.2%, 15 min or more. For post-test counselling: 40.2% stated they were told only that the test was negative; 24.9% reported 2-6 min; 16.4% about 10 min; and 18.5%, 15 min or more. The percentage of participants who reported no counselling time was higher among those tested in general health services: primary care, hospital settings and private laboratories (over 40% in pre-test, over 50% in post-test counselling). Women received less counselling time than men in almost all settings.
  
  
  CONCLUSIONS
  Policies to expand HIV testing in general health services should take this current medical behaviour into account. Any mention of the need for counselling can be a barrier to expansion, because HIV is becoming less of a priority in developed countries. Oral consent should be the only requirement.
authors.affiliation: Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Hoyos Miller
authors.affiliation: Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain; Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain. Electronic address: soniafb@isciii.es.
authors.forename: Sonia
authors.initials: S
authors.lastname: Fernández-Balbuena
authors.affiliation: Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: María José
authors.initials: MJ
authors.lastname: Belza Egozcue
authors.affiliation: Servei d'Epidemiologia, Agencia de Salut Pública de Barcelona, Barcelona, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: García de Olalla
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Jose
authors.initials: J
authors.lastname: Pulido Manzanero
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Molist Señe
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Spain; Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: de la Fuente de Hoz
mesh_terms: D015492:AIDS Serodiagnosis; D000328:Adult; D003376:Counseling / Q000706:statistics & numerical data*; D057210:Delayed Diagnosis / Q000517:prevention & control; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D004651:Employment; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units; D011320:Primary Health Care; D011477:Sex Work / Q000706:statistics & numerical data; D012725:Sexual Behavior; D013030:Spain; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: HIV; Health policy; Políticas de salud pública; Políticas sanitarias; Prevención; Prevention; Public health policy; Sexually transmitted disease; VIH; infecciones de transmisión sexual