Impact of counseling in voluntary counseling and testing programs for persons at risk for or living with HIV infection
Impact of counseling in voluntary counseling and testing programs for persons at risk for or living with HIV infection
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DOI：
10.1086/522544
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发表时间：
2007-12-15
影响因子：
11.8
通讯作者：
McGuire, Jean
中科院分区：
文献类型：
--
作者：
Holtgrave, David;McGuire, Jean
感染人类免疫缺陷病毒（HIV）或有感染风险的人需要以客户为中心的咨询和有关疾病的信息。提供咨询和信息的最佳机会之一是在艾滋病毒检测过程中。疾病控制和预防中心的新检测指南鼓励在检测前后减少咨询。我们回顾了有关自愿咨询和检测（VCT）的证据。同行评审的科学期刊明确支持将自愿咨询和检测作为预防艾滋病毒感染的一系列循证干预措施的一部分。对于血清检测呈阳性的人，VCT有影响，但很难将咨询的影响与检测的影响分开。对于血清反应阴性的人，在临床环境中进行咨询对危险行为和性传播疾病的发病率具有有益的影响，而且实施成本很低。在“典型”咨询不符合以客户为中心的咨询标准的情况下，它应该得到改善，而不是放弃，但我们可能需要在医疗保健系统中招募社区服务组织和非临床医生来实现这一目标。
Persons with or at risk for human immunodeficiency virus (HIV) infection need client-centered counseling and information about the disease. One of the best opportunities to provide counseling and information is during an HIV testing encounter. New testing guidelines from the Centers for Disease Control and Prevention encourage less counseling before and after testing. We review the evidence regarding voluntary counseling and testing (VCT). There is clear endorsement in peer-reviewed scientific journals for VCT as part of an evidence-based bundle of interventions to prevent HIV infection. For persons who test seropositive, VCT has an impact, but it is hard to uncouple the impact of counseling from that of testing. For persons who test seronegative, counseling in clinical settings has a beneficial impact on risk behaviors and sexually transmitted disease incidence and costs very little to implement. In settings where "typical" counseling is not up to client-centered counseling standards, it should be improved, not abandoned, but we may need to recruit community service organizations and nonclinicians in the health care system to achieve this aim.