A positive effect of cumulative intergroup threat on reproductive success.

Outgroup conflict is a powerful selective force across all social taxa. While it is well documented that individual outgroup contests can have a range of direct and indirect fitness consequences, the cumulative pressure of outgroup threats could also potentially impact reproductive success. Here, we use long-term life-history data from a wild population of dwarf mongooses (Helogale parvula) to investigate how intergroup interaction (IGI) rate might influence breeding and offspring survival. IGI rate did not predict the number of litters produced in a season or the inter-litter interval. Unexpectedly, IGI rate was positively associated with the number of pups alive three months after emergence from the breeding burrow. This was not due to a difference in how many pups emerged but because those in groups experiencing more IGIs had a higher survival likelihood post-emergence. Detailed natural observations revealed that both IGI occurrence and the threat of intergroup conflict led to more sentinel behaviour by adults, probably reducing the predation risk to young. Our results contrast the previously documented negative effects of outgroup interactions on reproductive success and highlight the need to assess cumulative threat, rather than just the impact of physical contests, when considering outgroup conflict as a social driver of fitness.

Behavioural, demographic and fitness consequences of social instability in cooperatively breeding dwarf mongoose groups.

Social instability frequently arises in group-living species, but the potential costs have rarely been investigated in free-living cooperative breeders, especially across different timeframes. Using natural observations, body mass measurements and life-history data from dwarf mongooses (Helogale parvula), we determined the short- and long-term consequences of a change in one of the dominant breeding pairs. We found that a new breeder led to alterations in both collective and individual behaviours (i.e. increases in communal scent-marking, engagement in intergroup interactions, sentinel activity and within-group grooming), as well as reduced body mass gain, further demographic changes and decreased reproductive success (i.e. fewer pups surviving to adulthood). The effects were particularly apparent when it was the female breeder who changed; new female breeders were younger than more experienced counterparts. Our findings support the idea that stability and cooperation are strongly linked and provide potential reasons for previously documented health and fitness benefits of social stability.

An Implementation Evaluation of the Comprehensive Addiction Recovery Act (CARA) Policy in New Mexico.

PURPOSE: The purpose of this field report is to describe an evaluation of the fidelity with which the comprehensive addiction and recovery act (CARA) policy has been implemented in New Mexico. DESCRIPTION: The CARA program in New Mexico focuses on providing nonpunitive supportive care for pregnant people affected by substance use and on coordinating services for parents, caregivers, and family members of newborns affected by substance exposure. The evaluation used information from program reports, a family follow-up survey, the plan of safe care database, and a data linkage between CARA participant records with Medicaid claims data. RESULTS: Follow-up survey data substantiated the program reports. Both sources showed that families were not engaged consistently in developing or receiving information about plans of safe care. The survey answers also indicated that the time-period immediately after the delivery of a baby is not the best time to communicate the contents of the plan of safe care to families. Additionally, the survey found that respondents believed that medical staff judged them for using substances during pregnancy. The Medicaid data linkage showed that 40.3% of families of infants exposed to substances in-utero did not receive a plan of safe care. Program reports revealed that limited resources existed for implementing CARA. CONCLUSION: Program funding, limited system capacity, lack of systematic screening for prenatal substance use, regional differences in access to care, and provider biases toward pregnant people using substances affected health-care workers' ability to identify at-risk families and develop plans of safe care. To support CARA implementation, healthcare systems must implement universal prenatal substance use screening, increase the level of anti-bias training pertaining to substance use, increase hospital supports, and improve data management systems.

What is already known on this subject? Stigma towards pregnant people for maternal substance use reduces access to prenatal care due to fear of involvement from child protective services. Punitive approaches to perinatal substance use result in lower healthcare utilization and opportunities to treat substance use disorder. What this study adds? This field report evaluates the implementation of a non-punitive state level policy meant to increase services for pregnant people using substances and reduce reports to child protective services for abuse neglect due to infants exposed to substances prenatally.

Extended and cumulative effects of experimentally induced intergroup conflict in a cooperatively breeding mammal.

Conflict between rival groups is rife in nature. While recent work has begun exploring the behavioural consequences of this intergroup conflict, studies have primarily considered just the 1-2 h immediately after single interactions with rivals or their cues. Using a habituated population of wild dwarf mongooses (Helogale parvula), we conducted week-long manipulations to investigate longer-term impacts of intergroup conflict. Compared to a single presentation of control herbivore faeces, one rival-group faecal presentation (simulating a territorial intrusion) resulted in more within-group grooming the following day, beyond the likely period of conflict-induced stress. Repeated presentations of outsider cues led to further changes in baseline behaviour by the end of the week: compared to control weeks, mongooses spent less time foraging and foraged closer to their groupmates, even when there had been no recent simulated intrusion. Moreover, there was more baseline territorial scent-marking and a higher likelihood of group fissioning in intrusion weeks. Consequently, individuals gained less body mass at the end of weeks with repeated simulated intrusions. Our experimental findings provide evidence for longer-term, extended and cumulative, effects of an elevated intergroup threat, which may lead to fitness consequences and underpin this powerful selective pressure.

Investigating the impact of anthropogenic noise on the decision-making of dwarf mongoose offspring.

Anthropogenic (man-made) noise constitutes a novel and widespread pollutant which is increasing in prevalence in terrestrial and aquatic ecosystems, resulting in alterations of natural soundscapes. There is proliferating evidence that noise leads to maladaptive behaviour in wildlife, yet few studies have addressed the effect on mammalian parent-offspring interactions. We investigated the impact of road noise on dwarf mongoose (Helogale parvula) offspring nearest-neighbour decision-making while foraging, using a field-based playback experiment. We predicted that offspring would forage closer to groupmates, especially adult and dominant individuals, when experiencing road noise compared with ambient sound to reduce communication masking and alleviate stress. We also predicted that noise would have a reduced effect with increasing offspring age owing to reduced reliance on adult groupmates for provisioning and predator defence. However, we found that mean nearest-neighbour distance and nearest-neighbour intrinsic characteristics (age, sex and dominance status) did not differ significantly between sound treatments, and these responses did not vary significantly with focal individual age. Noise may not impact nearest-neighbour decision-making owing to habituation from chronic natural exposure; alternatively, noise could induce stress and distraction, resulting in maladaptive decision-making. Future work should aim to detangle the underlying mechanisms mediating parent-offspring interactions in conditions of anthropogenic noise.

Comparison of demographic and behavioral characteristics of men who have sex with men by enrollment venue type in the National HIV Behavioral Surveillance System.

BACKGROUND: During 2003-2005, the National HIV Behavioral Surveillance System (NHBS) enrolled men who have sex with men (MSM) from 12 different venue types in 15 metropolitan areas in the United States. Our goal was to examine whether limiting NHBS enrollment venues to gay bars and dance clubs could increase efficiency without changing the overall results and conclusions. METHODS: We used logistic regression analysis to compare the demographic characteristics and reported HIV risk behaviors among MSM enrolled in gay bars and dance clubs with those enrolled in sex venues and those enrolled in other venues. RESULTS: Of the 11,471 eligible men included in the analysis, 6419 (56%) were enrolled at bars and clubs, 481 (4%) at sex venues, and 4571 (40%) at other venues. Compared with men enrolled at bars and clubs, men enrolled at sex venues were more likely to be older, of nonwhite race/ethnicity, bisexual, infrequent gay venue attendees, and to have 10 or more male sex partners in the past 12 months. Men enrolled at other venues were more likely to be older and less likely to use noninjecting drugs in the past 12 months. The absolute differences in these characteristics between men enrolled in bars and clubs and those enrolled in comparison venue categories were small in most instances. CONCLUSIONS: Although the differences in characteristics by venue category were not large in magnitude, there was evidence that restricting NHBS enrollment to bars and clubs would affect national estimates of behavioral risk factors among MSM.

Fitness consequences of outgroup conflict.

In social species across the animal kingdom, conspecific outsiders threaten the valuable resources of groups and their members. This outgroup conflict is recognised as a powerful selection pressure, but we argue that studies explicitly quantifying the fitness consequences need to be broader in scope: more attention should be paid to delayed, cumulative, and third-party fitness consequences, not just those arising immediately to group members involved in physical contests. In the first part of this review, we begin by documenting how single contests can have survival and reproductive consequences either immediately or with a delay. Then, we step beyond contests to describe fitness consequences that can also result from interactions with cues of rival presence and the general landscape of outgroup threat, and beyond single interactions to describe cumulative effects of territorial pressure and elevated outgroup-induced stress. Using examples from a range of taxa, we discuss which individuals are affected negatively and positively, considering both interaction participants and third-party group members of the same or the next generation. In the second part of the review, we provide suggestions about how to move forward. We highlight the importance of considering how different types of outgroup conflict can generate different selection pressures and of investigating variation in fitness consequences within and between species. We finish by discussing the value of theoretical modelling and long-term studies of natural populations, experimental manipulations, and meta-analyses to develop further our understanding of this crucial aspect of sociality.

Variation between species, populations, groups and individuals in the fitness consequences of out-group conflict.

Out-group conflict is rife in the natural world, occurring from primates to ants. Traditionally, research on this aspect of sociality has focused on the interactions between groups and their conspecific rivals, investigating contest function and characteristics, which group members participate and what determines who wins. In recent years, however, there has been increasing interest in the consequences of out-group conflict. In this review, we first set the scene by outlining the fitness consequences that can arise immediately to contest participants, as well as a broader range of delayed, cumulative and third-party effects of out-group conflict on survival and reproductive success. For the majority of the review, we then focus on variation in these fitness consequences of out-group conflict, describing known examples both between species and between populations, groups and individuals of the same species. Throughout, we suggest possible reasons for the variation, provide examples from a diverse array of taxa, and suggest what is needed to advance this burgeoning area of social evolution. This article is part of the theme issue 'Intergroup conflict across taxa'.

Experimental evidence for delayed post-conflict management behaviour in wild dwarf mongooses.

In many species, within-group conflict leads to immediate avoidance of potential aggressors or increases in affiliation, but no studies have investigated delayed post-conflict management behaviour. Here, we experimentally test that possibility using a wild but habituated population of dwarf mongooses (Helogale parvula). First, we used natural and playback-simulated foraging displacements to demonstrate that bystanders take notice of the vocalisations produced during such within-group conflict events but that they do not engage in any immediate post-conflict affiliative behaviour with the protagonists or other bystanders. We then used another playback experiment to assess delayed effects of within-group conflict on grooming interactions: we examined affiliative behaviour at the evening sleeping burrow, 30-60 min after the most recent simulated foraging displacement. Overall, fewer individuals groomed on evenings following an afternoon of simulated conflict, but those that did groomed more than on control evenings. Subordinate bystanders groomed with the simulated aggressor significantly less, and groomed more with one another, on conflict compared to control evenings. Our study provides experimental evidence that dwarf mongooses acoustically obtain information about within-group contests (including protagonist identity), retain that information, and use it to inform conflict-management decisions with a temporal delay.

Social animals that live in groups often have disagreements over access to mates and food. Even fleeting in-group disputes can be costly, disrupting relationships, wasting time and energy, or causing injury if aggression escalates. So, much like humans, many social animals, including primates, birds and dogs, have evolved conflict management strategies to prevent and resolve in-group disagreements. In the immediate aftermath of a conflict, this usually involves changes in the interactions between those involved in the disagreement, or between bystander groupmates and either the victim or aggressor. Less is known about whether social animals can recall past disputes and if they can use conflict management strategies some time after a quarrel has occurred. That is, do aggressive interactions between groupmates influence later social decisions of bystanders in the group? To investigate, Morris-Drake et al. studied groups of wild dwarf mongooses (Helogale parvula) that have become accustomed to living alongside humans in Limpopo Province, South Africa. Dwarf mongooses live in groups of up to 30 individuals, with one dominant breeding pair and lower-ranked helpers. When disagreements arise over food, an aggressor growls deeply and hip-slams the victim away from their foraging patch, stealing the victim's prey in the process. Victims often produce high-pitched squeals in retreat. Using recordings of these calls, Morris-Drake et al. devised a field experiment to investigate how mongooses responded to nearby conflicts between other group members. Recordings simulating a conflict over food were played to groups of foraging mongooses over the course of an afternoon, so that group members effectively heard what sounded like repeated squabbles between two out-of-sight individuals. Similar to natural conflicts, the mongooses did not engage in any obvious conflict management behaviour immediately after hearing these disputes. But when the group returned to their sleeping burrow that evening, subordinate group members shunned the perceived aggressors from grooming, a key social activity. This work provides evidence that dwarf mongooses keep tabs on conflicts that occur between groupmates. It shows these animals can extract information about conflicts from vocal cues alone and that bystanders use this information when making later social decisions impacting group dynamics. It also adds to growing evidence from baboons, monkeys and chimpanzees that social animals can remember past events and take these into account when interacting with groupmates.

Experimental field evidence that out-group threats influence within-group behavior.

In social species, conspecific outsiders present various threats to groups and their members. These out-group threats are predicted to affect subsequent within-group interactions (e.g., affiliation and aggression) and individual behavior (e.g., foraging and vigilance decisions). However, experimental investigations of such consequences are rare, especially in natural conditions. We used field-based call playbacks and fecal presentations on habituated wild dwarf mongooses (Helogale parvula)-a cooperatively breeding, territorial species-to examine postinteraction responses to the simulated threat of a rival group. Dwarf mongooses invested more in grooming of groupmates, foraged closer together, and more regularly acted as sentinels (a raised guard) after encountering indicators of rival-group presence compared to control conditions. These behavioral changes likely arise from greater anxiety and, in the case of increased vigilance, the need to seek additional information about the threat. The influence of an out-group threat lasted at least 1 h but individuals of different dominance status and sex responded similarly, potentially because all group members suffer costs if a contest with rivals is lost. Our results provide field-based experimental evidence from wild animals that out-group threats can influence within-group behavior and decision making, and suggest the need for greater consideration of the lasting impacts of social conflict.

HIV behavioral surveillance among the U.S. general population.

HIV behavioral surveillance in the United States is conducted among three groups: infected populations, high-risk populations, and the general population. We describe the general population component of the overall U.S. HIV behavioral surveillance program and identify priority analyses. This component comprises several data systems (ongoing, systematic, population-based surveys) through which data on risk behaviors and HIV testing are collected, analyzed, and disseminated. Multiple data systems are needed to balance differences in scope and purpose, as well as strengths and weaknesses of the sampling frames, mode of administration, and frequency of data collection. In a concentrated epidemic, such as in the United States, general population data play a small but important role in monitoring the potential spread of infection more broadly, particularly given increases in HIV transmission through heterosexual contact.

Anthropogenic noise alters dwarf mongoose responses to heterospecific alarm calls.

Anthropogenic noise is an evolutionarily novel and widespread pollutant in both terrestrial and aquatic habitats. Despite increasing evidence that the additional noise generated by human activities can affect vocal communication, the majority of research has focused on the use of conspecific acoustic information, especially sexual signals. Many animals are known to eavesdrop on the alarm calls produced by other species, enhancing their likelihood of avoiding predation, but how this use of heterospecific information is affected by anthropogenic noise has received little empirical attention. Here, we use two field-based playback experiments on a habituated wild population of dwarf mongooses (Helogale parvula) to determine how anthropogenic noise influences the response of foragers to heterospecific alarm calls. We begin by demonstrating that dwarf mongooses respond appropriately to the alarm calls of sympatric chacma baboons (Papio ursinus) and tree squirrels (Paraxerus cepapi); fleeing only to the latter. We then show that mongoose foragers are less likely to exhibit this flee response to tree squirrel alarm calls during road-noise playback compared to ambient-sound playback. One explanation for the change in response is that noise-induced distraction or stress result in maladaptive behaviour. However, further analysis revealed that road-noise playback results in increased vigilance and that mongooses showing the greatest vigilance increase are those that do not subsequently exhibit a flee response to the alarm call. These individuals may therefore be acting appropriately: if the greater gathering of personal information indicates the absence of an actual predator despite an alarm call, the need to undertake costly fleeing behaviour can be avoided. Either way, our study indicates the potential for anthropogenic noise to interfere with the use of acoustic information from other species, and suggests the importance of considering how heterospecific networks are affected by this global pollutant.

Use of and exposure to HIV prevention programs and services by persons at high risk for HIV.

Although HIV information is widely available in this country, little is known about how commonly used HIV prevention activities reach persons at highest risk for HIV. In this paper, we describe the extent to which HIV prevention strategies reach a sample of high-risk persons and whether such exposure correlates with having been tested for HIV. Data are from the 2000 HIV Testing Survey, an anonymous interview study of men who have sex with men (MSM), injection drug users (IDU), and high-risk heterosexuals (HRH), recruited from appropriate venues in seven states and New York City. We report the proportion of persons exposed to three types of interventions: information (media messages, brochures), counseling or skills-building (group counseling, role play, calling an AIDS hotline), and prevention supplies (provision of condoms, bleach kits), stratified by HIV testing status (ever, never). Exposure to information interventions was high among 2491 respondents (85%-96%) and did not differ by testing status. Use of counseling or skills-building interventions varied by testing status for IDU (8% untested versus 41% tested, p < 0.01) and HRH (14% versus 20%, p = 0.03) but not MSM (15% versus 23%, p = 0.08). Among tested IDU, those receiving bleach kits were more likely to report consistent bleach use when injecting with nonsterile needles (25% versus 9%, p = 0.003). Exposure to HIV prevention information is high but exposure to counseling or skills-building interventions is less common and more prevalent among those previously tested. Prevention initiatives should focus on counseling and testing, skills-building, and prevention supplies.

Cross-modal impacts of anthropogenic noise on information use.

Anthropogenic noise is a global pollutant, and there is rapidly accumulating evidence of impacts on a range of animal taxa [1,2]. While many studies have considered how additional noise may affect information provision and use, they have focused on the masking and consequent alteration of acoustic signals and cues; so-called unimodal effects [3]. Using field-based experimental trials on habituated wild dwarf mongooses (Helogale parvula) [4], we combine sound playbacks and faecal presentations to demonstrate that anthropogenic noise can disrupt responses to information from different sensory modalities. The adaptive, stronger response exhibited towards predator faeces compared with control faeces in ambient-noise conditions was detrimentally affected by road-noise playback. Specifically, having taken longer to detect the faeces, the mongooses interacted less with the predator cue, did not show increased vigilance following its detection, and spent less time in the safe vicinity of a burrow refuge, thus suffering a potentially increased predation risk. Our results are the first to show that anthropogenic noise could alter responses to olfactory cues, strongly indicating the possibility of cross-modal impacts of noise pollution on information use [3].

Strengthening the Reporting of Observational Studies in Epidemiology for respondent-driven sampling studies: "STROBE-RDS" statement.

OBJECTIVES: Respondent-driven sampling (RDS) is a new data collection methodology used to estimate characteristics of hard-to-reach groups, such as the HIV prevalence in drug users. Many national public health systems and international organizations rely on RDS data. However, RDS reporting quality and available reporting guidelines are inadequate. We carried out a systematic review of RDS studies and present Strengthening the Reporting of Observational Studies in Epidemiology for RDS Studies (STROBE-RDS), a checklist of essential items to present in RDS publications, justified by an explanation and elaboration document. STUDY DESIGN AND SETTING: We searched the MEDLINE (1970-2013), EMBASE (1974-2013), and Global Health (1910-2013) databases to assess the number and geographical distribution of published RDS studies. STROBE-RDS was developed based on STROBE guidelines, following Guidance for Developers of Health Research Reporting Guidelines. RESULTS: RDS has been used in over 460 studies from 69 countries, including the USA (151 studies), China (70), and India (32). STROBE-RDS includes modifications to 12 of the 22 items on the STROBE checklist. The two key areas that required modification concerned the selection of participants and statistical analysis of the sample. CONCLUSION: STROBE-RDS seeks to enhance the transparency and utility of research using RDS. If widely adopted, STROBE-RDS should improve global infectious diseases public health decision making.

Assessing the assumptions of respondent-driven sampling in the national HIV Behavioral Surveillance System among injecting drug users.

Several assumptions determine whether respondent-driven sampling (RDS) is an appropriate sampling method to use with a particular group, including the population being recruited must know one another as members of the group (i.e., injection drug users [IDUs] must know each other as IDUs) and be networked and that the sample size is small relative to the overall size of the group. To assess these three assumptions, we analyzed city-specific data collected using RDS through the US National HIV Behavioral Surveillance System among IDUs in 23 cities. Overall, 5% of non-seed participants reported that their recruiter was "a stranger." 20 cities with multiple field sites had ≥1 cross-recruitment, a proxy for linked networks. Sample sizes were small in relation to the IDU population size (median = 2.3%; range: 0.6%- 8.0%). Researchers must evaluate whether these three assumptions were met to justify the basis for using RDS to sample specific populations.

Prevalence of treatment optimism-related risk behavior and associated factors among men who have sex with men in 11 states, 2000-2001.

Sustainable behavior change among men who have sex with men (MSM) may be threatened by optimistic beliefs about HIV treatments: treatment optimism has been associated with high risk sexual behaviors. We used data from behavioral surveys of MSM attending gay bars in 11 states from 2000-2001 to describe the prevalence and correlates of being less careful with sex or drugs because of treatment optimism (optimism-related risk behavior). Fifteen percent of 1477 HIV-negative or -untested MSM reported optimism-related risk behavior. Optimism-related risk behavior was reported more often by Black and Hispanic MSM (versus white), more often by MSM with a high school education or less (versus college), and less often by MSM in some states. HIV prevention programs should address treatment optimism and related behavioral risks by providing culturally appropriate information, accessible to MSM with lower educational attainment, about the limitations of current therapies.

Human immunodeficiency virus (HIV) risk, prevention, and testing behaviors--United States, National HIV Behavioral Surveillance System: men who have sex with men, November 2003-April 2005.

PROBLEM/CONDITION: For CDC's goal of reducing the number of new human immunodeficiency virus (HIV) infections to be achieved, data are needed to assess the prevalence of HIV-related risk behaviors at a given time, monitor trends in these behaviors, and assess the correlates of risk. These data also can be used to evaluate the extent to which current HIV-prevention programs are reaching targeted communities and direct future HIV-prevention activities to reduce HIV transmission. REPORTING PERIOD: November 2003-April 2005. DESCRIPTION OF SYSTEM: The National HIV Behavioral Surveillance (NHBS) System collects risk behavior data from three populations at high risk for HIV infection: men who have sex with men (MSM), injection-drug users, and heterosexual adults in areas in which HIV is prevalent. Data collection began in 2003 among MSM in 17 U.S. metropolitan statistical areas (MSAs), and surveys have been conducted in 25 MSAs since 2005. Participants must be aged >/= 18 years and reside in a participating MSA. RESULTS: This report summarizes data gathered during the first cycle (i.e., data collection period) of NHBS (November 2003-April 2005) from approximately 10,000 MSM. The results indicated that >90% of participants had ever been tested for HIV. Of those, 77% had been tested during the preceding 12 months. In addition to their male sex partners, 14% of participants also had at least one female sex partner during the preceding 12 months. Unprotected anal intercourse was reported by 58% with a main male partner (someone with whom the participant had sex and to whom he felt most committed [e.g., a boyfriend, spouse, significant other, or life partner]) and by 36[corrected]% with a casual male partner (someone with whom the participant had sex but who was not considered a main partner). Noninjection drugs were used by 42% of participants during the preceding 12 months; the most commonly used drugs were marijuana (77%), cocaine (37%), ecstasy (29%), poppers (28%), and stimulants (27%). A substantial proportion (80%) of participants had received free condoms during the preceding 12 months, but fewer had participated in individual- or group-level HIV prevention programs (15% and 8%, respectively). INTERPRETATION: MSM surveyed engaged in sexual and drug-use behaviors that placed them at increased risk for HIV infection. The majority of MSM surveyed had been tested for HIV infection. Although a substantial proportion of participants had received free condoms, a much smaller proportion had participated in more intensive HIV-prevention programs. PUBLIC HEALTH ACTION: NHBS data are used to assess and develop effective HIV-prevention programs and services. Continued collection and reporting of NHBS data from all targeted high-risk populations is needed to monitor behavior trends and assess future HIV prevention needs in these populations. The data are used for local HIV-prevention planning and monitoring in MSAs in which NHBS is conducted.

Failure to return for HIV test results among persons at high risk for HIV infection: results from a multistate interview project.

BACKGROUND: Voluntary counseling and testing is an important strategy for HIV prevention. For optimal impact, however, clients must return for HIV test results and counseling. The goal of this study was to document the frequency of self-reported failure to return for HIV test results (FTR) and associated reasons among persons at high risk for HIV infection. METHODS: Respondents were recruited at gay bars (men who have sex with men [MSM]), by street intercept (injection drug users [IDUs]), or at sexually transmitted disease clinics (high-risk heterosexuals [HRHs]) in 7 US states in 2000. Self-reported history of and reasons for FTR were evaluated. RESULTS: FTR was commonly reported among 2241 respondents: 10% of MSM, 20% of HRHs, and 27% of IDUs reported FTR at least once. FTR was significantly (P < 0.05) more common among those with higher perceived risk of HIV infection and significantly less common among HRHs who had completed more than high school (vs. high school or General Education Development certificate) or were employed part time (vs. unemployed). About one fourth of respondents cited fear of getting test results as an important reason for FTR. CONCLUSION: Self-reported occurrences of FTR in our venue-recruited sample were similar to proportions of FTR previously reported from publicly funded venues. Increased pretest counseling on fear of learning HIV status and on the availability of rapid testing may help to reduce FTR.