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Thursday, January 2, 2014

Treatment Center On Site HIV Testing Declines

English: Pacific Ocean (Nov. 18, 2004) - Hospi...
When one is in the grips of addiction, sound decision making goes out the window. Those who use their drugs intravenously will often share needles despite the risks and the availability of clean needles at any pharmacy in the country. When opioid addicts decide to get help and seek out treatment, many of them have the desire to be tested for HIV and hepatitis C; however, a new report has shown that getting such testing can be difficult.

Researchers, Marcus A. Bachhuber, M.D., and Chinazo O. Cunningham, M.D., M.S. at the Albert Einstein College of Medicine, New York, analyzed data from a survey sent to directors of drug treatment facilities. They compiled the data to find the percentage of opioid treatment programs offering on-site HIV, STI, and HCV testing from 2000 to 2011.

The number of U.S. opioid treatment programs increased testing from 849 in 2000 to 1,175 in 2011. Clearly, over a ten year period there was not much of a change in the number of people tested. For-profit treatment centers increased testing from 43 percent to 54 percent, while nonprofits decreased from 43 percent to 36 percent, and public treatment programs decreased from 14 percent to 10 percent.

Between 2000 and 2011, programs offering testing for HIV, STIs, and HCV increased. However, the percentage offering on-site HIV testing declined by 18 percent and for STIs by 13 percent. It is clear, despite guidelines recommending routine opt-out HIV testing in all health care settings, on-site testing for HIV and other sexually transmitted infections declined substantially between 2000 and 2011.

"Opioid dependence is a risk factor for HIV, STIs, and hepatitis C virus (HCV) infection. Opioid treatment programs, which provide treatment to more than 300,000 opioid-dependent individuals in the United States, are well-positioned to offer testing for these infectious diseases to a high-risk population. They were among the first venues to offer HIV testing and are more likely to offer HIV, STI, and HCV testing than other drug treatment programs. Private for-profit opioid treatment programs are increasingly widespread and such programs offer on-site HIV testing less often than nonprofit and public programs. However, with the 2006 national recommendations for routine opt-out HIV testing, we hypothesized that the percentage of programs offering on-site testing for HIV, STIs, and HCV would increase," the authors write.

"Declines were most pronounced in for-profit programs, suggesting that persons enrolled in these programs may be at increased risk for delayed diagnosis and continued transmission of HIV, STIs, and HCV," according to the report.

"Opioid treatment programs are important venues for offering testing to high-risk individuals. As the number of for-profit opioid treatment programs increases, and the opioid, HIV, and HCV epidemics continue to intersect, further work is needed to understand and reverse declines in offering on-site testing."  

The study was published in JAMA.
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1 comment:

  1. Given the actions taken by the CDC and the U.S. Preventive Task Force this last year, I am surprised to see this. Hopefully a report like this will help show the reasons why there needs to be on-site testing of HCV and HIV.


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