HIV risk-reduction: Counselor training for a randomized clinical trial.

In 2010, the National Drug Abuse Treatment Clinical Trials Network (CTN) completed a study designed to evaluate strategies for providing rapid HIV testing in substance use treatment programs (protocol CTN-0032). Counselors from 12 sites across the U.S. were trained to provide on-site rapid HIV testing and a manualized HIV risk reduction counseling intervention based on the RESPECT-2 model (CDC, 2010). The training team was responsible for three aspects of intervention: counselor training, fidelity monitoring, and ongoing counseling supervision. Training occurred in three phases and were audio-taped. Ten percent of the recorded trainings were randomly reviewed by trained fidelity raters to ensure fidelity. To strengthen counselor skills by reinforcing proper techniques and sharing constructive input, the training/supervision team provided real time written feedback to counselors on randomly reviewed sessions. Raters assessed required activities, using a 4-point scale. Audiotapes that average above 1.5 were categorized as “good” and those over 2.5 as “excellent.” Of 198 audiotapes reviewed, 188 (94.9%) were rated “excellent” and the remaining 10 (5.2%) “good.” A subset of 35 audiotapes was reviewed by multiple raters and inter-rater agreement was 97.1%. Through an intensive training implementing a variety of training modalities, substance use counselors with no prior training or experience in HIV risk reduction counseling successfully conducted rapid HIV testing and HIV risk reduction counseling with substance use treatment clients.

Related protocols: CTN-0032