Low Rates of Adoption and Implementation of Rapid HIV Testing in Substance Use Disorder Treatment Programs

• We examine the availability and use of on-site rapid HIV testing (RHT).
• Most opioid treatment programs (OTP) do not offer on-site RHT.
• The availability of RHT on-site reduced the likelihood that an OTP did not test any of its clients.
• Among OTPs that conducted any HIV testing, availability of RHT on-site was not associated with increased number of clients tested.
• New strategies are needed to promote the adoption of RHT on-site and the offer of RHT when it is available.

IntroductionRapid HIV testing (RHT) greatly increases the proportion of clients who learn their test results. However, existing studies have not examined the adoption and implementation of RHT in programs treating persons with substance use disorders, one of the population groups at higher risk for HIV infection.MethodsWe examined 196 opioid treatment programs (OTPs) using data from the 2011 National Drug Abuse Treatment System Survey (NDATSS). We used logistic regressions to identify client and organizational characteristics of OTPs associated with availability of on-site RHT. We then used zero-inflated negative binomial regressions to measure the association between the availability of RHT on-site and the number of clients tested for HIV.ResultsOnly 31.6% of OTPs offered on-site rapid HIV testing to their clients. Rapid HIV testing was more commonly available on-site in larger, publicly owned and better-staffed OTPs. On the other hand, on-site rapid HIV testing was less common in OTPs that prescribed only buprenorphine as a method of opioid dependence treatment. The availability of rapid HIV testing on-site reduced the likelihood that an OTP did not test any of its clients during the prior year. But on-site availability rapid HIV testing was not otherwise associated with an increased number of clients tested for HIV at an OTP.ConclusionsNew strategies are needed to a) promote the adoption of rapid HIV testing on-site in substance use disorder treatment programs and b) encourage substance use disorder treatment providers to offer rapid HIV testing to their clients when it is available.