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RESPECT-2

Project RESPECT (see above) showed that two risk-reduction counseling sessions can prevent sexually transmitted diseases (STDs); however, return rates for test results were often low in standard clinic practice at the time this study was conducted. Thus, RESPECT-2 was a randomized, controlled trial that compared rapid HIV testing and counseling in 1 visit with standard Project RESPECT HIV testing and counseling in 2 visits. Main outcomes were STDs within 12 months. Participants were 15- to 39-year-old STD clinic patients in Denver, Long Beach, and Newark. Counseling was completed by 99% of the rapid-test group and 69% of the standard-test group. Self-reported behavior was similar in both groups and there was no significant difference in STD rates between the two groups overall at 12 months. However, STD incidence was significantly higher in the rapid-test group than in the standard-test group among men, and approached significance for men who had sex with men, and persons with no STDs at enrollment. This led to the conclusion that counseling with either test had similar effects on

STD incidence, but that for some persons, counseling with standard testing may be more effective than counseling with rapid testing. RESPECT-2 also became one of the interventions promoted to prevention practitioners through the CDCs Diffusion of Effective Behavioral Interventions (DEBI) program.