title: HIV testing among young adults and older adolescents in the setting of acute substance abuse treatment.
abstract: 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.
authors.affiliation: Division of Pediatric Infectious Diseases, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02093, U.S.A. Dpugatch@lifespan.org
authors.forename: D L
authors.initials: DL
authors.lastname: Pugatch
authors.forename: B G
authors.initials: BG
authors.lastname: Levesque
authors.forename: M A
authors.initials: MA
authors.lastname: Lally
authors.forename: S E
authors.initials: SE
authors.lastname: Reinert
authors.forename: W J
authors.initials: WJ
authors.lastname: Filippone
authors.forename: C M
authors.initials: CM
authors.lastname: Combs
authors.forename: T P
authors.initials: TP
authors.lastname: Flanigan
authors.forename: L K
authors.initials: LK
authors.lastname: Brown
mesh_terms: 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
chemical_list: D015483:HIV Antibodies