HIV antibody testing and client retention in the therapeutic community: A preliminary report of Phoenix House

• Published in: Journal of substance abuse treatment Vol. 11; no. 5; pp. 481 - 488
• Main Authors: Gonzalez, Isidoro, Rosenthal, Mitchell S., Bigler, Mark O., Alper, Kenneth, Geringer, Wendy
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.1994; Elsevier Limited
• Subjects: Acquired Immune Deficiency Syndrome; Adult; AIDS Serodiagnosis - psychology; client retention; Combined Modality Therapy; Comorbidity; Counseling; Cross-Sectional Studies; Female; Health Care Utilization; HIV; HIV counseling; HIV Seropositivity - epidemiology; HIV Seropositivity - psychology; HIV testing; Human immunodeficiency virus; Humans; Illness Behavior; Incidence; Length of Stay - statistics & numerical data; Male; New York - epidemiology; New York City, New York; Patient Dropouts - psychology; small group; Substance abuse treatment; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Substance-Related Disorders - rehabilitation; Therapeutic Community; Treatment Methods; New York; USA; HIV testing; HIV counseling; small group; therapeutic community; client retention
• ISSN: 0740-5472; 1873-6483
• DOI: 10.1016/0740-5472(94)90102-3

This report describes the current approach to testing for the human immunodeficiency virus (HIV) antibody at Phoenix House, a large therapeutic community (TC) in the northeastern United States, and presents findings on retention of clients who have been tested for HIV antibodies and notified of their HIV serostatus. A total of 240 clients were tested while in treatment at Phoenix House between April 1988 and July 1992. Of these, 51 tested HIV positive. An additional 76 clients had tested positive for HIV antibodies prior to entering treatment. The differences in length of treatment stay between those who tested negative while in treatment and those who tested positive while at Phoenix House was not significant ( t = 0.41, df = 238, p > .683). Although clients who tested seronegative during treatment were found to remain in treatment a significantly longer amount of time than the total population of seropositive clients ( t = 4.54, df = 314, p < .001), those who learned of their seropositive status while in treatment remained in the program longer than clients who entered treatment aware of their seropositivity ( t = 4.08, df = 125, p < .001). These findings suggest that acute reactions to the knowledge of seropositivity did not determine most premature terminations. The use of a small group, a core technical element of the TC, may have provided a favorable context for the task of HIV counseling and testing.