Rapid HIV Tests With Post-Test Counseling ‘More Efficient, Effective’ Than Current Counseling Procedures, Researchers Write in Letter to Lancet

Rapid HIV testing should be offered to "all people," with "selected" post-test counseling, Mary Jane Rotheram-Borus and Mark Etzel of the University of California-Los Angeles Neuropsychiatric Institute write in a letter published in the Feb. 15 issue of the Lancet. That model would be "more efficient and effective" than the typical current model of a 10-minute pre-testing counseling session, they write. The current method "imposes burdens" on developing countries with high HIV prevalence, and it "does not clearly benefit" those who test negative in low-prevalence countries, such as the United States, Rotheram-Borus and Etzel state. The recent FDA approval of a rapid HIV test that will let people know their infection status in one hour could help "eliminat[e] the 700,000 HIV tests for which people never return for their results," according to Rotheram-Borus and Etzel. The authors state that post-test counseling might only be needed for those who test positive or for those who say they engage in high-risk behaviors. They conclude, "Stopping pre-test counseling in the United States ... would allow resources to be reallocated to greatly expand post-test counseling, referral and linkages to care for HIV-positive individuals" (Rotheram-Borus/Etzel, Lancet, 2/15).