Time devoted to pre- and post-HIV test counselling in different health services according to participants of a rapid testing program in Madrid, Spain

INTRODUCTION: 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.ResultsThe 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. Conclusion 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

INTRODUCCIÓN: Las nuevas estrategias para reducir el diagnóstico tardío de VIH ponen en entredicho el papel del consejo pre-post test. Existe poca información sobre el tiempo dedicado al consejo. Un posible enfoque es explorar las opiniones de los pacientes sobre el tiempo dedicado al consejo según el lugar de la última prueba MÉTODOS: Se analizan 1568 personas con prueba previa de VIH que acuden a un programa móvil en Madrid entre Mayo y Diciembre de 2008. RESULTADOS: 71% eran hombres (48% hombres que tienen sexo con hombres), 51% < 30 años, 40% extranjeros, 56% universitarios y el 40% se hizo la última prueba en el ultimo año. Con respecto al consejo pre-test, el 30% refirió que únicamente se les comunicó que se les iba a realizar la prueba, el 26,3% reportó < 10 minutos, 20,4% alrededor de 10 y 24,2% 15 o más. Para el consejo post-test: el 40% refirió que únicamente se les comunicó el resultado negativo, 24,9% entre 2-6 minutos, 16,4% alrededor de 10 y 18,5% 15 o más. El porcentaje de participantes que dijo no recibir consejo fue mayor entre quienes se la habían hecho en servicios generales: atención primaria, hospitales y laboratorios privados (más del 40% en pre-test y más del 50% en post-test). En prácticamente todas las localizaciones, a las mujeres se les dedicó menos tiempo. CONCLUSIÓN: Las políticas para expandir la prueba de VIH en servicios generales deben considerar el comportamiento médico actual. Cualquier mención a la necesidad de consejo puede resultar una barrera a la expansión puesto que el VIH ya no es prioridad en los países desarrollados. El consentimiento verbal debiera ser el único requisito

Time devoted to pre- and post-HIV test counselling in different health services according to participants of a rapid testing program in Madrid, Spain.

INTRODUCTION: 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. CONCLUSION: 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.