PROJECT ACCESS - Drug Users' Counseling and Testing Experience

Access to HIV counseling and testing

Almost all of our participants had accessed HIV C&T
Most felt that it was not difficult to get an HIV test, while also acknowledging barriers listed above affecting themselves and their associates

Motivation to Test

Participants frequently reported a combination of motivators including: Convenience; Incentives offered; Known risk, or HIV positive sex or drug using partner; Entering drug treatment and recommended to test; Entering the Criminal Justice System and recommended to test; Told to test regularly (6 month intervals)

Venue for Testing

Participants had positive and negative views on all testing venues:
Venues varied including: CJS; health clinics; mobile vans; other research studies, hospital, and drug treatment centers

The C&T experience was often defined by the test result

If the result was negative it was a "good" or "fine" testing experience
Counseling experiences that providers would describe as suboptimal, were not perceived as such by the clients
General lack of "consumer consciousness" in regards to HIV counseling

Confidentiality and Anonymity

Frequently participants could not differentiate between confidential and anonymous testing.

Risk Assessment and Risk Reduction

Testing was a reported risk reduction strategy
Drug use risk reduction involved cutting down or stopping injection drug and other drug use; accessing clean needles through needle exchange programs; and bleaching needles. Awareness of drug related high risk was generally high among participants
Respondents described sexual risk reduction techniques including:
- talking to partners about HIV and their history before having sex
- using condoms until they "felt they could trust" their partners
- getting tested after beginning a new relationship, with or without initial condom use.

Referrals for High Risk HIV Negative Participants

Participants seemed to fall into three groups in regards to referrals:

Participants who felt they needed referrals and HIV-related and other services but could not access those services because they were not HIV positive; and
Participants who felt that because they were HIV negative they had no need for HIV- related services (including prevention services).
Participants who accessed HIV prevention and other HIV-related services (primarily needle exchange and drug treatment) on their own or due to having an HIV infected partner.

Repeat Testing

The idea that HIV can remain in the body, undetected by HIV tests, for up to ten years was prevalent among participants. Some respondents felt they had not put themselves at risk in several years, but they continued to get tested every 6 months, because the virus "might still show up." Other participants tested regularly because they were IDUs and were encouraged to test every six months by health care providers.