Missed Opportunity? Low Rates of Rapid HIV Testing In Opioid Treatment Programs

Despite the high prevalence of HIV among patients with substance use disorder, barriers to routine testing persist at treatment programs. Rapid HIV testing (RHT) presents an opportunity for increased testing and result delivery to patients. Using data from the National Drug Abuse Treatment System Survey, the authors conducted a cross-sectional analysis of the adoption and implementation of RHT in 196 opioid treatment programs (OTPs).

• 32% of OTPs offered on-site RHT to their clients.
• On-site RHT was less common in OTPs offering buprenorphine only (adjusted odds ratio [aOR], 0.21). At borderline significance, RHT was more common in large OTPs serving  > 600 patients (aOR, 2.92; 95% CI 0.88–9.67), despite large variation in the size of OTPs responding to the survey.
• The availability of on-site RHT reduced the likelihood that an OTP did not test any of its clients during the prior year. However, availability of on-site RHT was not associated with an increased number of patients tested for HIV at an OTP.

Comments:

This study confirms the low availability of RHT in OTPs nationwide, but it did not investigate theoretical barriers to offering RHT, including concerns over false positives (especially in low-prevalence areas) and access to public funding to provide this service. Future research should investigate barriers and strategies to increase RHT adoption in OTPs.

Jeanette M. Tetrault, MD

Reference:

Frimpong JA, D’Aunno T, Helleringer S, Metsch LR. Low rates of adoption and implementation of rapid HIV testing in substance use treatment programs. J Subst Abuse Treat. 2016;63:46–53.