title: Evaluating the implementation of nurse-initiated HIV rapid testing in three Veterans Health Administration substance use disorder clinics.
abstract: Individuals with substance use disorders (SUDs) are at higher risk of HIV infection, yet recent studies show rates of HIV testing are low among this population. We implemented and evaluated a nurse-initiated HIV oral rapid testing (NRT) strategy at three Veterans Health Administration SUD clinics. Implementation of NRT includes streamlined nurse training and a computerized clinical reminder. The evaluation employed qualitative interviews with staff and a quantitative evaluation of HIV testing rates. Barriers to testing included lack of laboratory support and SUD nursing resistance to performing medical procedures. Facilitators included the ease of NRT integration into workflow, engaged management and an existing culture of disease prevention. Six-months post intervention, rapid testing rates at SUD clinics in sites 1, 2, and 3 were 5.0%, 1.1% and 24.0%, respectively. Findings indicate that NRT can be successfully incorporated into some types of SUD subclinics with minimal perceived impact on workflow and time.
authors.affiliation: Veterans Affairs Quality Enhancement Research Initiative (QUERI) for HIV and Hepatitis, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. conners84@gmail.com
authors.forename: E E
authors.initials: EE
authors.lastname: Conners
authors.forename: H J
authors.initials: HJ
authors.lastname: Hagedorn
authors.forename: J N
authors.initials: JN
authors.lastname: Butler
authors.forename: K
authors.initials: K
authors.lastname: Felmet
authors.forename: T
authors.initials: T
authors.lastname: Hoang
authors.forename: P
authors.initials: P
authors.lastname: Wilson
authors.forename: G
authors.initials: G
authors.lastname: Klima
authors.forename: E
authors.initials: E
authors.lastname: Sudzina
authors.forename: H D
authors.initials: HD
authors.lastname: Anaya
mesh_terms: D000328:Adult; D000368:Aged; D019411:Clinical Laboratory Techniques / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000628:therapy*; D058014:Veterans Health