A Randomized Controlled Trial Evaluating the Educational Effectiveness of a Rapid HIV Post-Test Counseling Video

"Many of the individuals most at risk for HIV infection (i.e., minority populations, women, adolescents) are also the most marginalized by our health care system. Lacking primary care providers, they rely on the Emergency Department (ED) for their health care needs and education," explained the authors. Using a study population composed of ambulatory patients recruited for rapid HIV testing in the ED, they conducted a prospective randomized controlled trial to compare the educational effectiveness of a 15-minute post-test counseling video with the normal practice of a session with an HIV counselor.

Eligible study patients included those who consented for rapid HIV testing and completed measures on condom intention and condom use self-efficacy. Before receiving their results, consenting participants were randomized to either a 15-minute HIV post-test educational video available in English/Spanish or to a post-test counseling session. Both groups then completed an assessment tool concerning HIV prevention and transmission.

Of the 128 participants, 61 were randomized to the video and 67 to counselors. The groups were similar with respect to gender, ethnicity, and experience with prior HIV testing. Mean knowledge scores were higher in the video group (76.20 percent vs. 69.3 percent; 90 percent CI for the difference, 2.8, 11.2). As the lower bound of the CI for the difference was higher than the lower equivalence boundary (-5 percent), the authors surmised that the video was at least as effective as the counselor education session.

"The use of an educational counseling video is a valid alternative for providing post-test education and prevention information during the waiting period associated with the 20-minute HIV rapid test. Without disruption in clinical flow, both testing and education can be accomplished in a meaningful way in a busy ED," the authors concluded.

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