Behavioral and psychosocial consequences of HIV antibody counseling and testing with African American women.

This study compared a sample of low-income African American women in the southeastern United States who had and had not yet undergone HIV counseling and testing on risk-related cognitive mediating variables and self-reported sexual behaviors. Four hundred sixty (N = 460) African American women were recruited from health clinics and community settings in a southern city. Forty-five percent of the women (n = 207) had undergone HIV counseling and testing, whereas 55% (n = 253) had never been tested. Women who were seropositive were excluded from the analyses. After providing informed consent, the women completed a battery of cognitive mediating measures assessing AIDS knowledge, attitudes theoretically relevant to risk reduction, and self-reported sexual behavior. In addition, each participant demonstrated condom application skills using a penile model. Women who had undergone testing were younger, rated HIV disease as more serious, considered AIDS a greater health concern, had more positive attitudes toward HIV prevention, expressed greater intentions to use condoms, and evidenced a greater commitment to self-protective behavior than women who were not yet tested. Women who had undergone HIV antibody testing, however, showed no differences in sexual behavior from women who were never tested. Sexual behavior, including numbers of partners, frequency of unprotected intercourse, and inconsistent condom use, left women in both groups at significant and comparable risk for HIV and sexually transmitted disease infection. HIV counseling and testing alone may not be effective primary prevention strategies for promoting risk reduction among African American women.