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Background: The Centers for Disease Control and Prevention (CDC) recommends voluntary HIV testing be performed for all persons seeking services at STD clinics and that persons with positive test results should receive HIV prevention counseling.
Objectives: To determine the percentages of new HIV positivity and among those, proportion of posttest counseling events at STD clinics.
Methods: Using the CDC HIV Counseling and Testing System database, we analyzed data from the 25 health departments that reported test-level data from STD clinics in 2007; variables included reason for visit, HIV testing history, test type (anonymous or confidential), test results, and posttest counseling (includes return of HIV test results). New HIV positivity was defined as a record for which there is a current positive HIV test result and no self-report of a previous positive HIV test.
Results: Of 430,775 records from STD clinics in 2007, 423,192 (98%) were for confidential testing, and 2,818 (0.7%) documented new HIV-positive tests. Posttest counseling was documented for 246,719 (57%) HIV tests overall and 2,037 (72%) records of new positive results. Of the 932 new HIV-positive results from records indicating a request for HIV testing as the reason for visit, 692 (74%) documented posttest counseling. Conclusions: At these STD clinics, a high percentage of tests were conducted confidentially, which may increase receipt of test results, but >25% of records did not document posttest counseling for new positive test results, even though the reason for the visit was to obtain an HIV test. Implications for Programs, Policy, and/or Research: STD programs should a) have clinic policies that ensure prompt receipt of HIV test results and posttest counseling for persons newly identified with HIV, b) document percentage of tested persons who receive their results, and c) consider rapid HIV testing when return of test results is low.