AEGiS-06IAC: Policy implications of the alternative test site program evaluation.

6th International AIDS Conference


San Francisco, California, USA — June 20-23, 1990

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Policy implications of the alternative test site program evaluation.

Int Conf AIDS 1990 Jun 20-23; 6:333 (abstract no. Th.D.829)
Ramirez A, Truax SR; Office of AIDS, California Department of Health Services, Sacramento, CA, USA

OBJECTIVE: Alternative Test Site (ATS) operations, counselor and client information was examined to assess program adequacy and effectiveness in serving all clients and reducing HIV infection risk.

METHODS: A comprehensive, on-site evaluation reviewed the administrative structure, practices and composition of ATS programs in 28 California health jurisdictions. Self-report surveys of ATS counselors and clients included a broad array of questions eliciting counselor and client behavior and opinion. Approximately 370 counselors were offered the questionnaire and 214 (58%) were returned. Of the 1374 client surveys distributed, 857 (62%) were returned.

RESULTS: Administrative reviews indicated excellent program development and implementation. Counselor responses demonstrated a high level of competence and experience. Counselors reported a need to enhance their counseling skills (55%) useful with less cooperative or emotional client and to better maintain their AIDS knowledge (47%). Minority clients were clearly underserved. Hispanic clients averaged half their population representation (11.6% vs 23.2%). Repeat testing among clients was substantial (39%). Although most clients were at risk (88%), only 39% reported using a condom during their last sexual intercourse. While 65% of repeat clients perceived their current risk as much reduced, only homosexual clients reported higher condom use when compared with first time testers reporting the same risk behavior (66% vs 48%).

CONCLUSION: Counselor continuing education is being expanded to include psycho-social and psycho-therapeutic skills training. A quarterly newsletter has been developed and a program learning text is under development to focus on maintaining counselor AIDS expertise. Expansion of the amount of educational material targeted to minorities has been undertaken. Affirmative action hiring in ATSs is being emphasized and the location of ATS sites is being reviewed with the specific goal of increasing minority participation. The high percentage of repeat testing and substantial risk among repeat clients has led to the decision to develop a separate counseling protocol for this group focusing on risk denial and resistance to risk reducing behavior. Emphasis on interdisciplinary cooperation is essential to provide necessary risk reducing, behavior change referral resources for chronically at-risk clients.

Keywords: AEGIS, Evaluation Studies, Public Policy, Counseling, Risk-Taking, Condoms, HIV Infections, Acquired Immunodeficiency Syndrome, Genetic Counseling, California, Human, nursing, education, genetics, ICA6KWDaegis,evaluationstudies,publicpolicy,counseling,risk-taking,condoms,hivinfections,acquiredimmunodeficiencysyndrome,geneticcounseling,california,human,nursing,education,genetics,ica6

900620
ThD829

Copyright © 1990 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.