To determine whether human immunodeficiency virus (HIV)-infected STD clinic patients receive needed services and to determine the social consequences of testing HIV-positive.
Sexually transmitted disease clinic patients in Baltimore, Miami, and Newark who had first been told about a positive HIV test 6 to 24 months previously were recontacted and interviewed.
Out of 416 persons we attempted to contact, we interviewed 142 who had first learned that they were HIV-infected 6 to 24 months previously. Most interviewees were male (57%), black (82%), and heterosexual and had a low socioeconomic status. Twenty-five percent said they had never received medical care for their HIV infection. Most of those not in care said they were never referred, were "in denial," or did not want medical care. Interviewees had disclosed their status selectively; but "because of HIV," 4% had lost a job, 1% had been asked to move by a landlord, and 1% had been assaulted. Seventy-six percent would recommend that others take an HIV test; 11% would not recommend it.
Most patients interviewed were getting medical care and, despite some negative consequences, most would recommend HIV testing to others. To identify and address local barriers to needed services, we suggest that clinic staff routinely recontact consenting HIV-infected patients after posttest counseling.
From the * Epidemiology and Surveillance Branch, Division of STD Prevention, National Center for HIV, STD and TB Prevention, and † Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia
The authors gratefully acknowledge Ray Ransom, Shahul Ebrahim, Lyn Finelli, Eileen Crayne, Russ Mognoni, James Gardner, Veronica McCants, Robert Bruscavage, Dona Walcott-Kelly, Joan Wright, Deborah Brothers, and Andy Lentz for their assistance in locating and interviewing patients; A. Cornelius Baker for his review of the study protocol; and WIlliam Kassler for his helpful comments on the manuscript.
Reprint requests: Information Dissemination, Communications Office, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road N.E., Mailstop E-06, Atlanta, GA 30333.
Correspondence: Peter Kilmarx, MD, The HIV/AIDS Collaboration, DMS 6 Building, Ministry of Public Health, Tivanon Road, Nonthaburi 11000 Thailand.
Received for publication May 23, 1997, revised September 12, 1997, and accepted September 12, 1997.