Background:
STD and HIV prevention programs demonstrated that receiving HIV test result by phone can increase rates of testing and obtaining results, and save staff time. However, many test counselors and clinicians maintain concerns about potential negative outcomes from receiving positive HIV results by phone, including breech of confidentiality, emotional distress, or loss to follow-up.

Objective:
Maintain quality counseling, support, referral, and partner services to clients receiving positive HIV test results by phone, while minimizing stress to staff giving results.

Method:
Multnomah County Health Department's STD Prevention Program, and HIV/HCV Community Programs began providing the option of receiving HIV test results by phone in 2004. Results are entered into a database so phone staff have rapid access. Clients must provide a pass-code, created at the time of testing to maintain confidentiality. Positive HIV results are given by DIS, asking clients to return in person for further counseling. Clients may choose to receive results in person instead of by phone at any time.

Result:
Over 150 clients have received positive HIV results by telephone with no problems. Most anonymous testers called back or returned to clinic for follow-up counseling, referral, and other services from DIS. In 2006, 100% of confidential testers received DIS services after initial receipt of positive result. Components supporting test counselors' confidence in a successful interaction include: systems facilitating prompt response to client calls and protection of the client's confidentiality; allowing clients to choose the best option for themselves; thorough pretest counseling to prepare for results; skills and attentiveness to rapidly establishing empathic rapport with clients over the phone.

Conclusion:
Offering HIV results is a client-centered, effective method to deliver both negative and positive results.

Implications:
Programs providing STD/HIV results should consider HIV results-by-phone systems to maximize client knowledge of HIV status.