HIV rapid testing in drug treatment: Comparison across treatment modalities.

Despite high rates of risky behavior among patients, many drug abuse treatment programs do not provide on-site HIV testing. This secondary analysis of data examined differences in outcome by program modality from a multi-site study in which 1281 HIV-negative patients in three methadone programs, seven non-methadone outpatient programs, and three 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 (National Drug Abuse Treatment Clinical Trials Network (CTN) protocol CTN-0032, “HIV Rapid Testing and 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 off-site condition. Utilizing the same statistical approach, the authors of this study 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.

Conclusions: 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. As sexual risk reduction counseling appeared to have no effect on sexual risk behaviors at 6 month follow-up, the inability to provide this counseling should not serve as a barrier to providing HIV testing. Training and funding to support widespread implementation of routine HIV testing in substance abuse programs should be pursued.

Related protocols: CTN-0032