title: Low Rates of Adoption and Implementation of Rapid HIV Testing in Substance Use Disorder Treatment Programs.
abstract: BACKGROUND
  Rapid HIV testing (RHT) greatly increases the proportion of clients who learn their test results. However, existing studies have not examined the adoption and implementation of RHT in programs treating persons with substance use disorders, one of the population groups at higher risk for HIV infection.
  
  
  METHODS
  We examined 196 opioid treatment programs (OTPs) using data from the 2011 National Drug Abuse Treatment System Survey (NDATSS). We used logistic regressions to identify client and organizational characteristics of OTPs associated with availability of on-site RHT. We then used zero-inflated negative binomial regressions to measure the association between the availability of RHT on-site and the number of clients tested for HIV.
  
  
  RESULTS
  Only 31.6% of OTPs offered on-site rapid HIV testing to their clients. Rapid HIV testing was more commonly available on-site in larger, publicly owned and better-staffed OTPs. On the other hand, on-site rapid HIV testing was less common in OTPs that prescribed only buprenorphine as a method of opioid dependence treatment. The availability of rapid HIV testing on-site reduced the likelihood that an OTP did not test any of its clients during the prior year. But on-site availability rapid HIV testing was not otherwise associated with an increased number of clients tested for HIV at an OTP.
  
  
  CONCLUSIONS
  New strategies are needed to a) promote the adoption of rapid HIV testing on-site in substance use disorder treatment programs and b) encourage substance use disorder treatment providers to offer rapid HIV testing to their clients when it is available.
authors.affiliation: Department of Health Policy and Management, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA. Electronic address: jf2584@cumc.columbia.edu.
authors.forename: Jemima A
authors.initials: JA
authors.lastname: Frimpong
authors.affiliation: Robert F. Wagner Graduate School of Public Service, New York University, 295 Lafayette Street, New York, NY, 10012, USA. Electronic address: tdaunno@nyu.edu.
authors.forename: Thomas
authors.initials: T
authors.lastname: D'Aunno
authors.affiliation: Department of Population, Family and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, 615N. Wolfe Street, Baltimore, MD, 21205, USA. Electronic address: sheller7@jhu.edu.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Helleringer
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA. Electronic address: lm2892@cumc.columbia.edu.
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Metsch
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D002047:Buprenorphine / Q000627:therapeutic use; D015658:HIV Infections / Q000175:diagnosis*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000188:drug therapy; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration*; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine
keywords: Adoption; HIV testing; Implementation; Rapid HIV testing; Substance use disorder treatment programs; Use of rapid HIV testing
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