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Never HIV Tested : Results of Screening Data from 12 Drug Treatment Programs in the CTN 0032 HIV Rapid Testing and Couns

Never HIV Tested : Results of Screening Data from 12 Drug Treatment Programs in the CTN 0032 HIV Rapid Testing and Counseling Study.

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Never HIV Tested : Results of Screening Data from 12 Drug Treatment Programs in the CTN 0032 HIV Rapid Testing and Couns

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  1. Never HIV Tested:Results of Screening Data from 12 Drug Treatment Programs in the CTN 0032 HIV Rapid Testing and Counseling Study Lisa Metsch, Raul Mandler, Dan Feaster, Lauren Gooden, Susan Tross, Louise Haynes, Antoine Douaihy, Moupali Das, Tiffany Kyle, Todd Korthuis, Robert Schwartz, Sarah Erickson, Ned Snead, James Sorensen, and Grant Colfax College on Problems of Drug Dependence 72nd Annual Meeting , Scottsdale, AZ June 12-17, 2010

  2. There are no financial disclosures/conflicts of interest Acknowledgements: NIDA Clinical Trials Network

  3. HIV Rapid Test FDA approved Only requires blood from a finger stick or oral fluid from a swab Results in 20 minutes Does not require laboratory facilities and can be done by drug counselors

  4. Late HIV Testing is CommonSupplement to HIV/AIDS Surveillance, 1996-2005 Among 281,421 persons receiving diagnoses of HIV infection, 45% had an AIDS diagnosis by 3 years after initial HIV diagnosis (“late testers”); 38.3% of persons with HIV diagnosis had AIDS within one year. Late testers, compared to those tested early were more likely to be: Older Men (Male IDUs and Male Heterosexuals) Heterosexual Non-White MMWR June 26, 2009 *34 states

  5. Benefits of Widespread HIV Screening Decreases spread of HIV: An HIV diagnosis is associated with reduction in high risk sexual and injection behaviors Improves survival: Linkage to care and treatment May reduce the stigma that is associated with testing based on risk

  6. Offering HIV Testing in Outpatient Health Care Settings CDC now recommends offering routine HIV testing to persons regardless of risk factors: Emergency Departments Sexually Transmitted Diseases (STD) Clinics Labor and Delivery Correctional Facilities Offices of Primary Care Physicians Drug Abuse Treatment Clinics

  7. The Case for Drug Treatment…. Fewer than 1/3 of U.S. drug treatment programs offer HIV testing* Less than ½ of CTN CTPs made HIV testing available either in the CTP, through referral or outsourced ** CTN provides an ideal setting to introduce routine, on-site rapid HIV testing and counseling * SAMHSA, 2007, National Survey of Substance Abuse Treatment Services **Brown et al. JSAT, 2007

  8. CTN 0032 • CTN 0032 is a multi-center HIV testing and counseling trial with individuals receiving drug abuse treatment in the U.S. • Primary Research Aim: To evaluate the more effective HIV testing strategy: (1) to increase receipt of HIV test results (2) to decrease HIV sexual risk behaviors

  9. Participating Sites CODA MCCA Wheeler CPCDS Glenwood Gibson Recovery Chesterfield Life Link Daymark LRADAC Morris Village La Frontera

  10. Community Treatment Programs Participating community treatment programs represented outpatient psychosocial, intensive outpatient, narcotic replacement, and residential; Selected programs had not offered on-site HIV testing in the previous 6 months before launching the study; Programs had to have a census of at least 300 unduplicated patients over a 4 month period

  11. Patient Inclusion Criteria Patients were screened for study eligibility and had to: Be seeking or currently receiving drug (inclusive of alcohol) abuse treatment services at the participating CTP Report being HIV-negative or HIV status unknown Not have received results of an HIV test initiated within the past 12 months

  12. HIV Testing – Screening Data • Total number of patients screened 2468 • 41.3% Female • 10.4% Hispanic • 27.1% Black • 55.7% White • 43.4% History of Injection Drug Use • 19.5% Recent Injection Drug Use

  13. HIV Testing – Screening Data • HIV Status (n=1912) • Negative - 96.5% • Positive - 3.5% • HIV Tested (n=2468) • In Last Year - 27.4% • > Year Ago - 52.4% • Never - 20.1%

  14. HIV Testing by GenderN = 2468

  15. HIV Testing by Race/EthnicityN= 2468 * Non-Hispanic; Note Other Category not shown

  16. HIV Testing by Ever IDUN = 2468

  17. HIV Testing by Recent IDUN = 2468

  18. HIV Testing by Treatment SiteN = 2468

  19. Odds of Never HIV Tested Gender, Age, Injection History & Race/Ethnicity controlled

  20. Implications • The majority of persons screened in CTPs not providing on-site HIV testing had not been tested in the past year; a minority have never been tested; • Blacks, IDUs, and older persons were more likely to have ever been tested for HIV; • Strategies are needed to increase uptake of HIV testing among persons with substance use disorders.

  21. “Seek, Test, Treat, and Retain”

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