Patient characteristics and availability of onsite non-rapid and rapid HIV testing in US substance use disorder treatment programs

Abraham, Amanda J.; O’Brien, Lauren; Knudsen, Hannah K.; Bride, Brian E.; Smith, G. Rush; Roman, Paul M.

doi:10.1016/j.jsat.2012.03.004

Cited by 10 publications

(13 citation statements)

References 37 publications

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“…Studies examining treatment programs affiliated with the Clinical Trials Network (CTN) indicate that a little over 48% of programs provide on-site testing (Abraham et al, 2013; Brown et al, 2006; Strauss, Des Jarlais, Astone, & Vassilev, 2003). Research on HIV services has also been reported using data from the National Drug Abuse Treatment System Survey (NDATSS).…”

Section: Discussionmentioning

confidence: 99%

Provision of onsite HIV Services in Substance Use Disorder Treatment Programs: A Longitudinal Analysis

Aletraris

Roman

2015

Journal of Substance Abuse Treatment

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The provision of HIV education and testing in substance use disorder (SUD) treatment programs is an important public health strategy for reducing HIV incidence. For many at-risk individuals, SUD treatment represents the primary point of access for testing and receiving HIV-related services. This study uses two waves of nationally representative data of 265 privately-funded SUD treatment programs in the U.S. to examine organizational and patient characteristics associated with offering a dedicated HIV/AIDS treatment track, onsite HIV/AIDS support groups, and onsite HIV testing. Our longitudinal analysis indicated that the majority of treatment programs reported providing education and prevention services but there was a small, yet significant, decline in the number of programs providing these services. Programs placed more of an emphasis on providing information on the transmission of HIV rather than on acquiring risk reduction skills. There was a notable and significant increase (from 26.0% to 31.7%) in programs that offered onsite HIV testing, including rapid HIV testing, and an increase in the percentage of patients who received testing in the programs. Larger programs were more likely to offer a dedicated HIV/AIDS treatment track and to offer onsite HIV/AIDS support groups, while accredited programs and programs with a medical infrastructure were more likely to provide HIV testing. The percentage of injection drug users was positively linked to the availability of specialized HIV/AIDS tracks and HIV/AIDS support groups, and the percentage of female clients was associated with the availability of onsite support groups. The odds of offering HIV/AIDS support groups were also greater in programs that had a dedicated LGBT track. The findings suggest that access to hospitals and medical care services is an effective way to facilitate adoption of HIV services and that programs are providing a needed service among a group of patients who have a heightened risk of HIV transmission. Nonetheless, the fact that fewer than one third of programs offered onsite testing, and, of the programs ones that do, fewer than one third of patients received testing, raises concern in light of federal guidelines.

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Section: Discussionmentioning

confidence: 99%

Provision of onsite HIV Services in Substance Use Disorder Treatment Programs: A Longitudinal Analysis

Aletraris

Roman

2015

Journal of Substance Abuse Treatment

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“…The lack of significant differences found in the present study in receipt of HIV test results may be attributed to the fact that the study design addressed major barriers to testing found in prior research including lack of funding and training (Abraham et al, 2012; Bini et al, 2011; Brown et al, 2006; 2007; Knudsen & Oser, 2008). Nevertheless, these findings of cross modality effectiveness of on-site testing, are very encouraging in light of the differences in implementation of HIV testing across modalities found in prior survey research (Brown et al, 2007; Polinksy et al, 1998; Pollack & D’Aunno, 2010).…”

Section: Discussionmentioning

confidence: 54%

“…Staff training in HIV testing for counselors and program administrators of drug treatment programs should be made widely available. Such training could be delivered through the State or Local Health Departments’ AIDS Administrations, through local medical schools, or through the regional Center for Substance Abuse Treatment’s Addiction Technology and Transfer Centers (Abraham et al, 2012). Funding is also needed to support testing.…”

Section: Discussionmentioning

confidence: 99%

“…Funding is also needed to support testing. Program administrators should contact their State and Local Health Departments to determine the availability of grant funding for this purpose as it has been found that substance abuse programs are not always aware of existing funding for HIV testing in their state (Abraham et al, 2012; Bini et al, 2011). …”

Section: Discussionmentioning

confidence: 99%

“…Identified barriers to providing HIV testing in substance abuse treatment programs include lack of funding and/or reimbursement for services, lack of medical staff, and lack of staff training (Abraham et al, 2012; Bini et al, 2011; Brown et al, 2006; 2007; Knudsen & Oser, 2008). Haynes and colleagues (2011) pointed out the need for a phlebotomist as well as the requirement for pre- and post-test risk reduction counseling (codified in some state regulations) constitute two additional barriers to the provision of testing.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

HIV rapid testing in drug treatment: comparison across treatment modalities

Schwartz

Stitzer

Feaster

et al. 2013

Journal of Substance Abuse Treatment

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Despite high rates of risky behavior among patients, many drug abuse treatment programs do not provide on-site HIV testing. This secondary analysis examined differences in outcome by program modality from a multi-site trial in which 1,281 HIV-negative patients in 3 methadone programs, 7 non-methadone outpatient programs, and 3 residential programs were randomly assigned to: (1) off-site referral for HIV risk reduction counseling and testing; or on-site rapid testing (2) with or (3) without risk reduction counseling. The parent study using generalized estimating equations with site as a cluster variable found significantly higher rates of HIV testing and feedback of results by 1 month post-enrollment for the combined on-site conditions compared to the offsite condition (RR=4.52, 97.5% CI (3.57, 5.72). Utilizing the same statistical approach, we found neither significant treatment modality nor significant treatment modality by testing condition interaction effects either for receipt of HIV test results at 1 month or for sexual or drug use HIV-risk behaviors at 6-month follow-up. On-site HIV testing is effective across treatment modalities for achieving high rates of testing and results feedback. All programs should be encouraged to adopt or expand this service.

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Uptake of HIV Testing in Substance Use Disorder Treatment Programs That Offer On-Site Testing

et al. 2014

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Increasing rates of HIV testing within substance use disorder (SUD) treatment clients is an important public health strategy for reducing HIV transmission rates. The present study examined uptake of HIV testing among 1224 clients in five SUD treatment units that offered on-site testing in Florida, New York, and California. Nearly one third (30%) of the participants, who had not previously tested positive, reported not having been tested for HIV within the past twelve months. Women, African Americans, and injection drug users had a higher likelihood of having been tested within the past twelve months. The SUD treatment program was the most frequently identified location of participants’ last HIV test. Despite the availability of free, on-site testing, a substantial proportion of clients were not tested, suggesting that strategies to increase uptake of testing should include addressing barriers not limited to location and cost.

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Patient characteristics and availability of onsite non-rapid and rapid HIV testing in US substance use disorder treatment programs

Cited by 10 publications

References 37 publications

Provision of onsite HIV Services in Substance Use Disorder Treatment Programs: A Longitudinal Analysis

Provision of onsite HIV Services in Substance Use Disorder Treatment Programs: A Longitudinal Analysis

HIV rapid testing in drug treatment: comparison across treatment modalities

Uptake of HIV Testing in Substance Use Disorder Treatment Programs That Offer On-Site Testing

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