TABLE 1.

ITERATIVE EVALUATION OF A MOBILE HIV COUNSELING AND TESTING PROGRAM

(1) Does mobile testing reach a different population than clinic-based health department testing?

Using culturally similar outreach workers in a mobile program targeting high risk venues reached populations that  were almost twice as likely to have never tested and significantly more likely to have had unprotected anal or vaginal  sex since their last test.

Health Department Testing (n = 1838)

People of color – 29%

Never tested – 22%

Unprotected anal or vaginal sex since last HIV test – 54%

CBO Testing (n=610)

People of color – 84% (p < 0.001)

Never tested – 40% (p < 0.001)

Unprotected anal or vaginal sex since last HIV test – 72% (p < 0.001)

(2) Does offering incentives increase identification of new positives?

A $10 incentive made the testing program four times more effective in reaching people at risk and identifying HIV  cases:

No Incentive – 362 tested (5 HIV positive)

$10 incentive – 1437 tested (25 HIV positive)

(3) How do alternative testing strategies impact program effectiveness?

Offering only rapid testing made the testing program almost twice as effective as when oral fluid testing was offered in  combination with other test strategies.

Oral fluid testing (n=829) – 55% received results

Rapid testing (n=1470) – 99% received results (p<0.001)

(4) How does interactive HIV computer counseling impact counseling quality, program productivity and evaluation  capabilities?

CBO staff and health department payers appreciated the impact of the CARE tool:

Counseling Quality – Minimally trained counseling staff appreciated the CARE tool guiding them through all key  components of counseling and felt that the program improved their ability to provide longitudinal counseling in the  field, through bringing up past risk behaviors and counseling plans.

Program Productivity – With the CARE tool staff did not have to spend time in the office entering data, and so could  spend more time out in the field reaching clients.

Timeliness of Evaluation Reports– Staff for the first time appreciated evaluation data because they received it in real  time and were able to better tailor outreach. Program administrators appreciated the automated evaluation reports  and for the first time were able to submit their reports on time to the health department and receive prompt payment.