HIV testing among young adults and older adolescents in the setting of acute substance abuse treatment.
OBJECTIVE
To examine the feasibility and acceptance of HIV testing among youth in acute substance abuse treatment.


METHODS
Youth, aged 18 to 25 years old, in state-funded inpatient detoxification completed a confidential demographic/risk behavior questionnaire, and were offered a choice of no testing, serum-based testing, or oral fluid (Orasure, Epitope, Inc., Beaverton, OR, U.S.A.) HIV testing.


RESULTS
In all, 74% of 204 participants accepted HIV testing. In a multivariate model, female gender (odds ratio [OR], 0.32; 95% confidence interval [CI] 0.14-0.74) and having been recently tested (OR, 0.11; 95% CI, 0.05-0.26) were independently associated with refusing testing. Recent sexual activity (OR, 5.4; 95% CI, 1.5-20.4), recent use of methamphetamines (speed) or a combination of cocaine and heroin (speedball) (OR, 3.8; 95% CI, 1.6-9.0), and a recent perceived risk for HIV (OR, 4.6; 95% CI, 1.9-10.9) were independently associated with test acceptance. Thus, 150 of 150 (100%) chose the Orasure test. Overall, 64.6% (97 of 150) of those tested received their results, but among participants requiring a follow-up appointment to learn test results, only 9.2% (8 of 87) returned.


CONCLUSIONS
HIV testing is feasible and acceptable in this population. All patients preferred Orasure testing to a serum enzyme-linked immunosorbent assay (ELISA). Most youth tested in detoxification will only learn their results if they are provided during treatment. Rapid HIV testing with same-day results could improve follow-up rates.
Pugatch
D L
DL
Division of Pediatric Infectious Diseases, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02093, U.S.A. Dpugatch@lifespan.org
Levesque
B G
BG
Lally
M A
MA
Reinert
S E
SE
Filippone
W J
WJ
Combs
C M
CM
Flanigan
T P
TP
Brown
L K
LK
D000293:Adolescent; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000175:diagnosis* / Q000635:transmission; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D012309:Risk-Taking; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000150:complications*; D011795:Surveys and Questionnaires
D015483:HIV Antibodies