title: HIV testing in the nation's opioid treatment programs, 2005-2011: the role of state regulations.
abstract: OBJECTIVE
  To identify the extent to which clients in a national sample of opioid treatment programs (OTPs) received HIV testing in 2005 and 2011; to examine relationships between state laws for informed consent and pretest counseling and rates of HIV testing among OTP clients.
  
  
  METHODS
  Data were collected from a nationally representative sample of OTPs in 2005 (n = 171) and 2011 (n = 200).
  
  
  METHODS
  Random-effects logit and interval regression analyses were used to examine changes in HIV testing rates and the relationship of state laws to HIV testing among OTPs.
  
  
  METHODS
  Data on OTP provision of HIV testing were collected in phone surveys from OTP managers; data also were collected on state laws for HIV testing.
  
  
  RESULTS
  The percentage of OTPs offering HIV testing decreased significantly from 93 percent in 2005 to 64 percent in 2011. Similarly, the percentage of clients tested decreased from an average of 41 percent in 2005 to 17 percent in 2011. OTPs located in states whose laws do not require pretest counseling and that use opt-out consent were more likely to provide HIV testing and to test higher percentages of clients.
  
  
  CONCLUSIONS
  The results show the need to increase HIV testing among OTP clients; the results also underscore the beneficial possibilities of dropping pretest counseling as a requirement for HIV testing and of using the opt-out approach to informed consent for testing.
authors.affiliation: Mailman School of Public Health, Columbia University, 600W. 168th St., New York, NY, 10032.
authors.forename: Thomas
authors.initials: T
authors.lastname: D'Aunno
authors.forename: Harold A
authors.initials: HA
authors.lastname: Pollack
authors.forename: Lan
authors.initials: L
authors.lastname: Jiang
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Metsch
authors.forename: Peter D
authors.initials: PD
authors.lastname: Friedmann
mesh_terms: D002047:Buprenorphine / Q000627:therapeutic use*; D003625:Data Collection; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006302:Health Services Research; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000331:legislation & jurisprudence*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D010342:Patient Acceptance of Health Care; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D014481:United States
chemical_list: D009292:Narcotic Antagonists; D002047:Buprenorphine
keywords: HIV testing; HIV/AIDS; health policy; opioid treatment; organizational factors; state regulation