title: Human immunodeficiency virus testing practices among buprenorphine-prescribing physicians.
abstract: BACKGROUND
  Despite the Centers for Disease Control and Prevention recommendations for annual HIV testing of at-risk populations, including those with substance use disorders, there are no data on the human immunodeficiency virus (HIV) testing practices of buprenorphine-prescribing physicians.
  
  
  OBJECTIVE
  To describe HIV testing practices among buprenorphine-prescribing physicians.
  
  
  METHODS
  We conducted a cross-sectional survey of physicians enrolled in a national system to support buprenorphine prescribing between July and August 2008. The electronic survey included questions on demographics; clinical training and experience; clinical practice; patient characteristics; and physician screening practices, including HIV testing.
  
  
  RESULTS
  Only 46% of 382 respondent physicians conducted HIV testing. On univariate analysis, physicians who conducted HIV testing were more likely to report addiction specialty training (33% vs 19%, P = 0.001), practicing in addiction settings (28% vs 16%, P = 0.006), and having treated more than 50 patients with buprenorphine (50% vs 31%, P < 0.0001) than those who did not. Compared with physicians who did not conduct HIV testing, physicians who conducted HIV testing had a lower proportion of buprenorphine patients who were white (75% vs 82%, P = 0.01) or dependent upon prescription opioids (57% vs 70%, P < 0.0001). In multivariate analysis, physicians who conducted HIV testing were more likely to have treated more than 50 patients with buprenorphine (odds ratio = 1.777, 95% CI 1.011-3.124) and had fewer patients dependent upon prescription opioids (odds ratio = 0.986 95% CI 0.975-0.998) than physicians who did not.
  
  
  CONCLUSIONS
  Interventions to increase HIV testing among physicians prescribing buprenorphine are needed.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars Program, Yale School of Public Health, New Haven, CT 06520, USA. ejennifer.edelmam@yale.edu
authors.forename: E Jennifer
authors.initials: EJ
authors.lastname: Edelman
authors.forename: An T
authors.initials: AT
authors.lastname: Dinh
authors.forename: Brent A
authors.initials: BA
authors.lastname: Moore
authors.forename: Richard S
authors.initials: RS
authors.lastname: Schottenfeld
authors.forename: David A
authors.initials: DA
authors.lastname: Fiellin
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Sullivan
mesh_terms: D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D002047:Buprenorphine / Q000627:therapeutic use*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D014481:United States; D014600:Utilization Review; D055815:Young Adult
chemical_list: D009294:Narcotics; D002047:Buprenorphine