Rapid testing and counseling research within the CTN.

A study of HIV rapid testing and counseling is being planned in the National Drug Abuse Treatment Clinical Trials Network. Among the million people living with HIV in the U.S., approximately one-fourth do not know they are infected. Identifying these individuals is among the biggest challenges for HIV prevention. Earlier diagnosis of such individuals, combined with prevention counseling and provision of health care could decrease the spread of HIV and improve the survival of HIV-infected persons. The Centers for Disease Control and Prevention (CDC) have made it a priority to bring HIV rapid testing and counseling into outpatient health care settings that serve populations both at moderate and high risk for HIV. These settings include emergency rooms, STD clinics, urgent care centers, hospitals, correctional settings, labor and delivery, and offices of primary care physicians. To date, there have been no wide-scale attempts to move HIV rapid testing and counseling into outpatient drug treatment settings. This is clearly a missed opportunity, because both injection and non-injection drug abuse continue to be important risk factors for HIV infection, with substance users at increased risk for HIV infection compared with the general population.

This presentation describes the new CTN HIV rapid testing and counseling study, which aims to conduct a randomized controlled trial to evaluate the effectiveness of implementing HIV rapid testing (results in 20 minutes) and counseling into drug treatment sites. The study will address these questions: How effective is offering routine, on-site HIV rapid testing and counseling in 1) increasing the number of drug treatment clients tested and identifying new HIV cases, and 2) reducing risk behaviors for drug-using clients in treatment? This study will also provide the opportunity to examine the organizational factors associated with the feasibility, acceptability and durability of implementing rapid testing and counseling into drug treatment.

Related protocols: CTN-0032