Direct evaluation of adolescent HIV counseling and testing services

The incidence of HIV disease in adolescents is increasing. Studies indicate this population is not receiving adequate information or support to bring about healthy behavior choices that prevent infection, reinfection, or infection of a partner. Physicians themselves, according to a study, are providing services well below the current established guidelines. The current study provides direct evaluation of services provided to youths by adolescents trained to address critical issues using fictional (undercover) stories at actual sites advertising HIV/AIDS counseling and testing to teenagers. Thirty-three health-care sites were identified within the Washington, DC, area; eight were eliminated during the process, leaving 25 sites for appraisal. Less than 40% of the participating clinics that advertised HIV testing qualified for recommendation. In addition, many female youth evaluators reported they received unsolicited advice regarding abstinence or reduction of sexual activity; male evaluators did not report similar findings. Results of the study were translated into recommendations in the form of reports to those sites that chose to receive them. The authors recommend implementing a similar study on an annual basis of similar sites with publication of results in order to improve staff training and maintain standards that will encourage adolescent and young adult clients to be tested and follow through for test results and appropriate education and counseling.