Counseling and Testing Intervention (C&T)

The C&T intervention was based on the United States Centers for Disease Control and Prevention’s client centered HIV counseling model. This HIV counseling model is distinguished by including personalized risk assessment and the development of a personalized risk reduction plan for each client.

Personalized risk reduction plans are designed to take into account each client’s level of knowledge, interpersonal situation, specific risk behaviors and readiness to change. In this counseling model, the content of the counseling sessions and the amount of counseling the client receives is individualized and determined by their specific issues regarding HIV risk reduction. This individualized model is also ideal to promote cultural specificity; at each site counselors were encouraged to take into account the specific cultural and environmental context of counseling at their site.

Participants enrolling as couples were counseled together or individually by their choice; some individual time with the counselor was given to assure accurate risk assessment. Couples were informed prior to HIV testing of the expectation that they would share their test results. Test results were given individually first, then the couple was encouraged to share their test results in the counseling session. Post-test counseling then proceeded with both members of the couple present.

While most participants were expected to test after the first counseling session, additional pre-test counseling sessions were offered as needed. Participants were asked to make a commitment to the counselor to return for their test results, and care was taken to address participants’ concerns about disclosure. While the previous experience of the study counselors varied from site to site, all counselors had previously worked as nurses, counselors or therapists and received extensive training and supervision in the specific counseling intervention used for the study.

Participants who tested on their initial baseline visit were scheduled to return for test result disclosure two weeks later. Participants who did not agree to be tested during their initial baseline visit scheduled an additional counseling appointment. Participants were allowed able to return for as many post-disclosure counseling sessions as requested. At the end of the baseline visit, all participants received a supply of 25 condoms and a brochure showing correct condom use, and were invited to return for additional condoms at any time.

Please see the counselor training manual used for this intervention.

Last modified: January 20, 2011