title: HIV rapid testing in drug treatment: comparison across treatment modalities.
abstract: Despite high rates of risky behavior among patients, many drug abuse treatment programs do not provide on-site HIV testing. This secondary analysis examined differences in outcome by program modality from a multi-site trial in which 1281 HIV-negative patients in three methadone programs, seven non-methadone outpatient programs, and three residential programs were randomly assigned to: (1) off-site referral for HIV risk reduction counseling and testing; or on-site rapid testing (2) with or (3) without risk reduction counseling. The parent study using generalized estimating equations with site as a cluster variable found significantly higher rates of HIV testing and feedback of results by 1 month post-enrollment for the combined on-site conditions compared to the offsite condition [RR=4.52, 97.5% CI (3.57, 5.72)]. Utilizing the same statistical approach, we found neither significant treatment modality nor significant treatment modality by testing condition interaction effects either for receipt of HIV test results at 1 month or for sexual or drug use HIV-risk behaviors at 6-month follow-up. On-site HIV testing is effective across treatment modalities for achieving high rates of testing and results feedback. All programs should be encouraged to adopt or expand this service.
authors.affiliation: Friends Research Institute, Baltimore, MD 21201, USA. rschwartz@friendsresearch.org
authors.forename: Robert P
authors.initials: RP
authors.lastname: Schwartz
authors.forename: Maxine L
authors.initials: ML
authors.lastname: Stitzer
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Feaster
authors.forename: P Todd
authors.initials: PT
authors.lastname: Korthuis
authors.forename: Anika A H
authors.initials: AA
authors.lastname: Alvanzo
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Winhusen
authors.forename: Lillian
authors.initials: L
authors.lastname: Donnard
authors.forename: Ned
authors.initials: N
authors.lastname: Snead
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Metsch
mesh_terms: D015492:AIDS Serodiagnosis / Q000379:methods*; D000328:Adult; D000367:Age Factors; D004522:Educational Status; D030141:Feedback, Psychological; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D007182:Income; D008297:Male; D016485:Needle Sharing / Q000523:psychology / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care; D012309:Risk-Taking; D012725:Sexual Behavior; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D047568:Unsafe Sex / Q000517:prevention & control / Q000523:psychology