A recent study in the Journal of Adolescent Health
examines the possible differences between telephone notification vs. face-to-face notification of HIV test results for high-risk youth.
All outreach testing sites were within the Portland, OR, metropolitan area. Organizations and individuals were identified and approached for participation in this study on the basis of recommendations from youth and health care professionals who work with homeless and high-risk youth. Events were scheduled, coordinated, and advertised to promote youth participation. Mobile health vans allowed testing at sites that would have otherwise been unfeasible.
A total of 351 HIV tests were performed. Youth aged 13 to 24, who requested HIV counseling and testing and were able to provide informed consent, were eligible for the study. All outreach testing was completed confidentially with client-centered individualized counseling. Oral HIV testing was performed.
Each youth randomly received an identification number. Odd numbers were assigned to the face-to-face notification group, and even numbers were assigned to either the face-to-face or telephone notification for HIV test results. The youth with an odd identification number had to receive the HIV test results in person while the youth with an even identification number could choose to either receive the results face-to-face or over the phone.
Information concerning demographics, risk behaviors, and HIV-testing history were collected. Behaviors considered high-risk included: injection drug use; sharing needles; trading sex for food, money, drugs, shelter, or protection; a sexual partner known as HIV positive; men who have sex with men (MSM); and those reporting high-risk sexual partners.
Youth were asked to rate their perceived risk for contracting HIV, quantify their number of sexual partners in the previous 12 months, and provide information about their use of barrier protection during sexual activity and use of drugs and alcohol with sexual behavior.
HIV Risk Behavior
- Nearly 52% of youth reported at least one of the high-risk behaviors.
- Approximately 11% of youth identified themselves as high risk for acquiring an HIV infection. Nonetheless, self-identified risk for HIV did not necessarily correspond to reported high-risk behaviors. A high number of youth reported high-risk behaviors but self-identified themselves as having no risk, unsure of risk, or low risk.
- 85% of the MSM self-identified as low risk, along with 54% of injection drug users, 67% of youth reporting survival sex, 77% of youth with an HIV-positive sexual partner, 14% of youth who share needles, and 75% of youth who reported high-risk sexual partners.
HIV Result Notification
- 48% of the youth followed up to receive test results and post test counseling; 37% in the face-to-face notification group compared with 58% in the telephone option group.
- Of the youth in the phone option group who received their results, 88% did so via telephone.
- Only two youth tested positive, both of whom had been assigned to the face-to-face notification group. Neither youth followed up on his or her own to receive their results and required referral to the county health department program.
- Participants between the ages of 19 and 24 were more likely to obtain their HIV test results than youth 13 to 18 years old. The proportion of youth who received their results increased significantly in both age groups with the option of telephone notification.
- Youth who identified themselves as white were more likely to follow up for results than youth who identified themselves as non-white. The phone option significantly increased result notification in both groups.
- MSM were significantly more likely to receive their results than men who did not report sex with men. The phone option significantly increased result notification in both groups.
- Phone notification did not significantly increase the proportion of intravenous drug users who received their results.
The authors believe their findings showed that younger adolescents, non-whites, and those with lower risk behavior were less likely to receive their results but that adding a phone notification option increased the proportion of youth who received their results.
The authors acknowledge that they were unable to specifically look at phone notification with HIV-positive youth because only two youth tested positive and both were assigned to the face-to-face notification group. Despite this limitation, the authors suggest the option of phone notification in a low-prevalence HIVand homeless and high-risk population of young people is an effective way to increase the proportion who receive post-test counseling and test results.
For more information: R.C. Tsu, et al., Telephone vs. Face-to-Face Notification of HIV Results in High-Risk Youth, Journal of Adolescent Health, vol. 30, pp. 154-60.