On-site HIV Testing Research Articles

A study protocol for Project I-Test: a cluster randomized controlled trial of a practice coaching intervention to increase HIV testing in substance use treatment programs

BackgroundPeople with substance use disorders are vulnerable to acquiring HIV. Testing is fundamental to diagnosis, treatment, and prevention; however, in the past decade, there has been a decline in the number of substance use disorder (SUD) treatment programs offering on-site HIV testing. Fewer than half of SUDs in the USA offer on-site HIV testing. In addition, nearly a quarter of newly diagnosed cases have AIDS at the time of diagnosis. Lack of testing is one of the main reasons that annual HIV incidences have remained constant over time. Integration of HIV testing with testing for HCV, an infection prevalent among persons vulnerable to HIV infection, and in settings where they receive health services, including opioid treatment programs (OTPs), is of great public health importance.Methods/designIn this 3-arm cluster-RCT of opioid use disorders treatment programs, we test the effect of two evidence-based “practice coaching” (PC) interventions on the provision and sustained implementation of on-site HIV testing, on-site HIV/HCV testing, and linkage to care. Using the National Survey of Substance Abuse Treatment Services data available from SAMHSA, 51 sites are randomly assigned to one of the three conditions: practice coach facilitated structured conversations around implementing change, with provision of resources and documents to support the implementation of (1) HIV testing only, or (2) HIV/HCV testing, and (3) a control condition that provides a package with information only. We collect quantitative (e.g., HIV and HCV testing at 6-month-long intervals) and qualitative site data near the time of randomization, and again approximately 7–12 months after randomization.DiscussionInnovative and comprehensive approaches that facilitate and promote the adoption and sustainability of HIV and HCV testing in opioid treatment programs are important for addressing and reducing HIV and HCV infection rates. This study is one of the first to test organizational approaches (practice coaching) to increase HIV and HIV/HCV testing and linkage to care among individuals receiving treatment for opioid use disorder. The study may provide valuable insight and knowledge on the multiple levels of intervention that, if integrated, may better position OTPs to improve and sustain testing practices and improve population health.Trial registrationClinicalTrials.gov NCT03135886. Registered on 2 May 2017.

Feasibility and preliminary effectiveness of integrating HIV prevention into an adolescent empowerment and livelihood intervention at youth clubs in rural Uganda

ABSTRACT The uptake of HIV prevention services is lower among youth than adults in sub-Saharan Africa. Existing youth livelihood trainings offer a potential entry point to HIV prevention services. We determined feasibility and preliminary effectiveness of integrating HIV prevention into youth clubs implementing an empowerment and livelihood for adolescents (ELA) intervention in rural Uganda. Staff conducted community mobilization for youth (15–24 years) over one month. Clubs met (3×/week) over six months, with local peer mentors trained to teach life-skills and sexual/reproductive health education. We integrated mentor-led education on HIV prevention, including pre- and post-exposure prophylaxis (PrEP/PEP). Clubs offered on-site HIV testing, a field trip to a local clinic and PrEP referrals after one month and six months. Surveys were conducted at baseline and six months. Forty-two participants (24 adolescent girls/young women (AGYW) and 18 adolescent boys/young men (ABYM)) joined the clubs. At baseline, no participants accepted referral for PrEP, whereas 5/18 (28%) sexually active, HIV-negative AGYW requested PrEP referral at follow-up. One ABYM requested PEP referral. Integration of HIV prevention services into an established ELA curriculum at mentor-led youth clubs in rural Uganda was feasible. PrEP uptake increased among sexually active AGYW. Evaluation of this approach for HIV prevention among youth merits further study.

Harm reduction and health services provided by syringe services programs in 2019 and subsequent impact of COVID-19 on services in 2020

ObjectivesThis study describes harm reduction and health services provided by U.S syringe services programs (SSPs) in 2019 and changes in provision of those services in 2020. MethodsSSPs were invited to participate in the Dave Purchase Memorial survey in August 2020. We collected programmatic data on services provided in 2019 and at the time of the survey in 2020. We conducted descriptive analyses using Chi-square and McNemar’s tests. ResultsAt the time of the survey, > 60% of SSPs reported increased monthly syringe and naloxone distribution and expansion of home-based and mail-based naloxone delivery in Fall 2020 compared to 2019. Approximately three-quarters of SSPs decreased or stopped providing on-site HIV and HCV testing. Nearly half of SSPs offering on-site medications for opioid use disorder (MOUD) in 2019 increased provision of MOUD in 2020. The proportion of SSPs offering on-site mental health care services and primary care services statistically significantly decreased from 2019 to Fall 2020, but telehealth offerings of these services increased. ConclusionsMany SSPs that offered health services in 2019 and remained operational in 2020 increased telehealth provision of mental health and primary care services, increased MOUD provision, and expanded harm reduction services, but most SSPs reduced or stopped on-site HIV and HCV testing. Sustaining SSP growth and innovation is paramount for preventing overdose deaths and HIV/HCV outbreaks after the deadliest year of the opioid epidemic in 2020.

Long-term follow-up of individuals under community supervision who refused rapid HIV testing

Many criminal justice-involved persons on probation or parole do not receive HIV testing despite being at an increased risk for infection and transmission. Between April, 2011 and May, 2012 in Baltimore, MD and Providence, RI, a two-group randomized controlled trial was conducted in order to examine the uptake of on-site rapid HIV testing compared to off-site referral-based HIV testing at a community clinic. Adults under community supervision were recruited to complete baseline assessments and then offered optional, free rapid-HIV testing. Of the 1263 participants who completed baseline measures, 566 declined HIV testing prior to randomization to the on-site testing at the Probation/Parole office or referral to off-site testing in a community health clinic. Follow-up data from 50 individuals who declined HIV testing were collected from September 2016–June 2017 and are examined in the present study. We describe the long-term outcomes of these 50 individuals in terms of HIV testing, HIV status, and frequencies of drug and sex risk behaviors.

Brief Report: Proportion and Predictors of Adult TB Contacts Accepting HIV Testing During an Active TB Case Finding Intervention in South Africa.

Many individuals at risk for HIV may be reached through active TB case finding interventions in areas with highly prevalent co-epidemics of TB/HIV. We analyzed data from a cluster-randomized trial of 2 TB case finding strategies: facility-based screening and contact investigation of newly identified TB cases. In both arms, on-site rapid HIV testing was offered to all contacts older than 18 months who did not self-report HIV-positive status. Those who were HIV infected were referred appropriately. All contacts 15 years and older were included in this analysis. Among 2179 contacts identified, 50% (1092) accepted HIV testing and counselling, of whom 6.3% (68) tested HIV-positive. Contacts who were unemployed [adjusted prevalence ratio (aPR) 1.14, 95% confidence interval (CI): 1.04 to 1.25], had not been to a clinic (aPR 1.09, 95% CI: 1.02 to 1.18) or HIV tested (aPR 1.25, 95% CI: 1.14 to 1.39) 6 months before, and those reporting gastrointestinal symptoms (aPR 1.22, 95% CI: 0.98 to 1.52) and genitourinary symptoms (aPR 1.30, 95% CI: 1.17 to 1.45) were significantly associated with accepting HIV testing. Women [adjusted odds ratio (aOR) 2.19, 95% CI: 1.26 to 3.81], individuals with a past history of tuberculosis (aOR 1.96, 95% CI: 0.93 to 4.14), and those not HIV tested 6 months before (aOR 2.20, 95% CI: 1.28 to 3.79) were significantly associated with testing HIV-positive. Offering HIV testing in the context of active tuberculosis case finding represents an opportunity to identify a large proportion of previously undiagnosed individuals with HIV in a population that might otherwise not seek testing.

The Impact of the SEERs Project on HIV Testing in Kenya.

Compared to other key populations, adolescents living in sub-Saharan Africa experience a high HIV disease burden. To address this, organizations have implemented a variety of youth-oriented HIV prevention strategies, including the HIV SEERs Project. SEERs is an innovative, community-based program designed with and for youth in Kenya to reduce HIV stigma (a known barrier to HIV testing), and increase treatment and retention in care. While preliminary research has demonstrated SEERs efficacy for increasing HIV knowledge and decreasing stigma, information about its efficacy as a means to increase HIV testing has been limited to assessing behavioral intentions. To address this limitation, SEERs facilitators partnered with 20 local HIV agencies in 2018 to offer on-site HIV testing during SEERs programming. The purpose of this article is to examine the impact, as well as the benefits and challenges of SEERs programming on HIV testing and linkage to care. SEERs facilitators collected and reported the following data monthly over the course of the year: number of locations for SEERs programming, number and age range of SEERs attendees, number of attendees who screened for HIV and, among those, the number who tested positive and were linked to care. Facilitators also provided written descriptions of the benefits and challenges of implementing the SEERs programming. We analyzed HIV testing data using descriptive statistics and used qualitative data to describe facilitators' perceptions of the benefits and challenges of implementing the SEERs program. We discuss the contributions of these findings to the existing literature and explore future directions.

HIV risk and pre-exposure prophylaxis interest among female bar workers in Dar es Salaam: cross-sectional survey

ObjectiveFemale bar workers (FBW) in East Africa often conduct sex work to supplement their incomes, and may be vulnerable to HIV acquisition. Pre-exposure prophylaxis (PrEP) offers protection against HIV acquisition....

Characterizing the HIV Care Continuum and Identifying Barriers and Facilitators to HIV Diagnosis and Viral Suppression Among Black Transgender Women in the United States.

Although black transgender women (BTW) experience high prevalence of HIV in the United States, no characterization of the HIV care continuum exists for this population. This study addresses this gap by (1) characterizing the HIV care continuum, and (2) exploring correlates of HIV diagnosis and viral suppression among a community-based sample of BTW. Data came from Promoting Our Worth, Equality, and Resilience (POWER). From 2014 to 2017, POWER recruited BTW who attended Black Pride events in 6 U.S. cities. Participants completed a behavioral health survey and were offered onsite HIV testing. Simple frequencies were used to characterize the HIV care continuum, and multivariable logistic regression analysis was used to identify correlates of HIV diagnosis and viral suppression. A total of 422 BTW provided completed data for our analysis, 45.0% of whom were living with HIV. Over half of the HIV-positive BTW (51.4%) reported being undiagnosed at the time of survey, and 24.5% reported viral suppression. Incarceration and a lack of access to medical care were significantly and positively associated with an undiagnosed HIV-positive status in multivariable models. Incarceration, homelessness, polydrug use, physical assault, intimate partner violence, and current hormone use were significantly and negatively associated with viral suppression in multivariable models. Developing and implementing interventions that address timely HIV diagnosis may assist in informing the HIV disparity among BTW in the United States. Interventions should address the fundamental causes of poor health in this population.

Venue-Based HIV-Testing: An Effective Screening Strategy for High-Risk Populations in Lima, Peru.

Venue-based testing may improve screening efforts for HIV and syphilis, thereby reducing transmission. We offered onsite rapid dual HIV and syphilis testing at venues popular among MSM and/or transgender women in Lima, Peru. We used Poisson regression to calculate adjusted prevalence ratios (aPRs) for factors associated with each infection. Most (90.4%) of the 303 participants would test more frequently if testing was available at alternative venues. New cases of HIV (69) and syphilis infection (84) were identified. HIV was associated with recent sex work (aPR 1.11; 95% CI 1.02-1.22), sex with a partner of unknown serostatus (aPR 1.18; 95% CI 1.09-1.27), exclusively receptive anal sex role (aPR 1.16; 95% CI 1.03-1.30) or versatile sex role (aPR 1.17; 95% CI 1.06-1.30) compared to insertive. Syphilis was associated with reporting role versatility (aPR = 2.69; 95% CI 1.52-5.74). Sex work venues had higher syphilis prevalence 47% versus 28% in other venues, p value = 0.012. Venue-based testing may improve case finding.

Evaluation of Senegal\u2019s prevention of mother to child transmission of HIV (PMTCT) program data for HIV surveillance

BackgroundWith the expansion of Prevention of Mother to Child Transmission (PMTCT) services in Senegal, there is growing interest in using PMTCT program data in lieu of conducting unlinked anonymous testing (UAT)-based ANC Sentinel Surveillance. For this reason, an evaluation was conducted in 2011–2012 to identify the gaps that need to be addressed while transitioning to using PMTCT program data for surveillance.MethodsWe conducted analyses to assess HIV prevalence rates and agreements between Sentinel Surveillance and PMTCT HIV test results. Also, a data quality assessment of the PMTCT program registers and data was conducted during the Sentinel Surveillance period (December 2011 to March 2012) and 3 months prior. Finally, we also assessed selection bias, which was the percentage difference from the HIV prevalence among all women enrolled in the antenatal clinic and the HIV prevalence among women who accepted PMTCT HIV testing.ResultsThe median site HIV prevalence using routine PMTCT HIV testing data was 1.1% (IQR: 1.0) while the median site prevalence from the UAT HIV Sentinel Surveillance data was at 1.0% (IQR: 1.6). The Positive per cent agreement (PPA) of the PMTCT HIV test results compared to those of the Sentinel Surveillance was 85.1% (95% CI 77.2–90.7%), and the percent-negative agreement (PNA) was 99.9% (95% CI 99.8–99.9%). The overall HIV prevalence according to UAT was the same as that found for women accepting a PMTCT HIV test and those who refused, with percent bias at 0.00%. For several key PMTCT variables, including “HIV test offered” (85.2%), “HIV test acceptance” (78.0%), or “HIV test done” (58.8%), the proportion of records in registers with combined complete and valid data was below the WHO benchmark of 90%.ConclusionsThe PPA of 85.1 was below the WHO benchmarks of 96.6%, while the combined data validity and completeness rates was below the WHO benchmark of 90% for many key PMTCT variables. These results suggested that Senegal will need to reinforce the quality of onsite HIV testing and improve program data collection practices in preparation for using PMTCT data for surveillance purposes.

A mixed methods study of HIV-related services in buprenorphine treatment

BackgroundOpioid use disorder (OUD) is a major risk factor in the acquisition and transmission of HIV. Clinical practice guidelines call for the integration of HIV services in OUD treatment. This mixed methods study describes the integration of HIV services in buprenorphine treatment and examines whether HIV services vary by prescribers’ medical specialty and across practice settings.MethodsData were obtained via qualitative interviews with buprenorphine experts (n = 21) and mailed surveys from US buprenorphine prescribers (n = 1174). Survey measures asked about screening for HIV risk behaviors at intake, offering HIV education, recommending all new patients receive HIV testing, and availability of on-site HIV testing. Prescribers’ medical specialty, practice settings, caseload demographics, and physician demographics were measured. Multivariate models of HIV services were estimated, while accounting for the nesting of physicians within states.ResultsQualitative interviews revealed that physicians often use injection behaviors as the primary indicator for whether a patient should be tested for HIV. Interviews revealed that HIV-related services were often viewed as beyond the scope of practice among general psychiatrists. Surveys indicated that prescribers screened for an average of 3.2 of 5 HIV risk behaviors (SD = 1.6) at intake. About 62.0% of prescribers delivered HIV education to patients and 53.2% recommended HIV testing to all new patients, but only 32.3% offered on-site HIV testing. Addiction specialists and psychiatrists screened for significantly more HIV risk behaviors than physicians in other specialties. Addiction specialists and psychiatrists were significantly less likely than other physicians to offer on-site testing. Physicians in individual medical practice were significantly less likely to recommend HIV testing and to offer onsite testing than physicians in other settings.ConclusionsBuprenorphine treatment providers have not uniformly integrated HIV-related screening, education, and testing services for patients. Differences by medical specialty and practice setting suggest an opportunity for targeting efforts to increase implementation.

What do You Need to Get Male Partners of Pregnant Women Tested for HIV in Resource Limited Settings? The Baby Shower Cluster Randomized Trial

Male partner involvement has the potential to increase uptake of interventions to prevent mother-to-child transmission of HIV (PMTCT). Finding cultural appropriate strategies to promote male partner involvement in PMTCT programs remains an abiding public health challenge. We assessed whether a congregation-based intervention, the Healthy Beginning Initiative (HBI), would lead to increased uptake of HIV testing among male partners of pregnant women during pregnancy. A cluster-randomized controlled trial of forty churches in Southeastern Nigeria randomly assigned to either the HBI (intervention group; IG) or standard of care referral to a health facility (control group; CG) was conducted. Participants in the IG received education and were offered onsite HIV testing. Overall, 2498 male partners enrolled and participated, a participation rate of 88.9%. Results showed that male partners in the IG were 12 times more likely to have had an HIV test compared to male partners of pregnant women in the CG (CG = 37.71% vs. IG = 84.00%; adjusted odds ratio = 11.9; p < .01). Culturally appropriate and community-based interventions can be effective in increasing HIV testing and counseling among male partners of pregnant women.

Low Rates of Adoption and Implementation of Rapid HIV Testing in Substance Use Disorder Treatment Programs

IntroductionRapid 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. MethodsWe 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. ResultsOnly 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. ConclusionsNew 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.

Review of HIV Testing Efforts in Historically Black Churches.

This paper aims to critically assess the state of HIV testing in African American churches. A comprehensive review of peer-reviewed publications on HIV testing in church-based settings was conducted by two independent coders. Twenty-six papers published between 1991 and 2015, representing 24 unique projects, were identified addressing at least one dimension of HIV testing. Thirteen faith-based projects have implemented HIV testing events or had clergy promote the importance of testing and knowing one’s HIV status, but empirical data and rigorous study designs were limited. Only eight papers reported onsite HIV testing in churches. Less than 5% of the studies reported the percentage of congregants who returned for their test results. Finally, no study has examined at baseline or post-intervention behavioral intentions to be screened for HIV. Future research is needed to evaluate the effectiveness of HIV testing in churches and to explore the possibilities of the role of the church and leadership structure in the promotion of HIV treatment and care.

Provision of onsite HIV Services in Substance Use Disorder Treatment Programs: A Longitudinal Analysis

The provision of HIV education and testing in substance use disorder (SUD) treatment programs is an important public health strategy for reducing HIV incidence. For many at-risk individuals, SUD treatment represents the primary point of access for testing and receiving HIV-related services. This study uses two waves of nationally representative data of 265 privately-funded SUD treatment programs in the U.S. to examine organizational and patient characteristics associated with offering a dedicated HIV/AIDS treatment track, onsite HIV/AIDS support groups, and onsite HIV testing. Our longitudinal analysis indicated that the majority of treatment programs reported providing education and prevention services, but there was a small, yet significant, decline in the number of programs providing these services. Programs placed more of an emphasis on providing information on the transmission of HIV rather than on acquiring risk-reduction skills. There was a notable and significant increase (from 26.0% to 31.7%) in programs that offered onsite HIV testing, including rapid HIV testing, and an increase in the percentage of patients who received testing in the programs. Larger programs were more likely to offer a dedicated HIV/AIDS treatment track and to offer onsite HIV/AIDS support groups, while accredited programs and programs with a medical infrastructure were more likely to provide HIV testing. The percentage of injection drug users was positively linked to the availability of specialized HIV/AIDS tracks and HIV/AIDS support groups, and the percentage of female clients was associated with the availability of onsite support groups. The odds of offering HIV/AIDS support groups were also greater in programs that had a dedicated LGBT track. The findings suggest that access to hospitals and medical care services is an effective way to facilitate adoption of HIV services and that programs are providing a needed service among a group of patients who have a heightened risk of HIV transmission. Nonetheless, the fact that fewer than one third of programs offered onsite testing, and, of the ones that did, fewer than one third of their patients received testing, raises concern in light of federal guidelines.

Sexual behaviour and HIV prevention needs of men attending a suburban Sex on Premises Venue.

Background Sexual behaviour and HIV prevention needs of men who have sex with men (MSM) attending suburban Sex on Premises Venues (SOPVs) are understudied. A cross-sectional survey examining sexual activity, health services utilisation, sexual health services needs and STI knowledge was conducted among MSM over 18 years old attending a SOPV in Western Sydney between June and July 2013. A total of 213 MSM were sampled; approximately half of the respondents (51%) reported that they only had sex with other men, and 46% had sex with both men and women. Condom use varied considerably, with ~50% of responders not using condoms consistently during anal sex. Consistent condom usage was not associated with having regular, casual or a mix of regular and casual partners during anal sex (P=0.09). The majority (59.5%) obtained sexual health screening services from general practitioners; only 15.0% sought services from a local sexual health clinic. Over half of respondents (57.7%) believed that SOPVs should offer on-site and free testing services. Those with the highest level of previous STI diagnoses were gay men (41%), those who only had casual partners (38%) and those who did not complete high school (65%). Sexual health services and non-government organisations should consider targeting bisexual men with rapid HIV testing and condom usage campaigns. Low cost or free on-site HIV and STI testing at SOPVs and stronger partnerships between general practitioners and sexual health services are needed.

Implementing solutions to barriers to on-site HIV testing in substance abuse treatment: A tale of three facilities

Due to the scarcity of resources for implementing rapid onsite HIV testing, many substance abuse treatment programs do not offer these services. This study sought to determine whether addressing previously identified implementation barriers to integrating on-site rapid HIV testing into the treatment admissions process would increase offer and acceptance rates. Results indicate that it is feasible to integrate rapid HIV testing into existing treatment programs for substance abusers when resources are provided. Addressing barriers such as providing start-up costs for HIV testing, staff training, addressing staffing needs to reduce competing job responsibilities, and helping treatment staff members overcome their concerns about clients’ reactions to positive test results is paramount for the integration and maintenance of such programs.

Presence of an HIV Testing Program Lowers the Prevalence of Unprotected Insertive Anal Intercourse Inside a Gay Bathhouse Among HIV-Negative and HIV-Unknown Patrons

This study sought to determine whether the presence of HIV testing inside a gay bathhouse reduced sexual risk behavior among patrons. A two-stage, time probability, cluster sample design recruited men exiting a northern California bathhouse in the last 5 weeks of 2001 (N = 440), when no HIV testing was offered inside the bathhouse, and again in the last 5 weeks of 2002 (N = 412), when HIV testing was offered 5 days a week. Separate logistic regression analyses compared a 2002 HIV testing exposure subgroup with both a 2001 nonexposure subgroup and a 2002 nonexposure subgroup for differences in sexual risk behavior during the bathhouse visit. Prevalence of unprotected insertive anal intercourse was significantly lower in the 2002 exposure subgroup than in the 2002 nonexposure subgroup. Similar results obtained when HIV-positive respondents were excluded. These results indicate onsite HIV testing has a preventive effect on some sexual risk behavior inside the bathhouse.

HIV/AIDS services in substance use disorder treatment programs within the clinical trials network

s / Drug and Alcohol Dependence 140 (2014) e86–e168 e107 ment prior to implementation of TRIP (Standard Practice Group); 255 clients entered treatment after TRIP implementation began and received Standard enhanced by TRIP. ANCOVAs were used to examine Time 2 differences by TRIP, Gender, and Attention groups, controlling for demographic and judgment measures at Time 1. Results: Compared to Standard Practice, adolescents receiving TRIP scoredhigher onDecision-Making (DM), evenafter controlling for Gender, Drug use Severity, Age, Juvenile Justice Involvement, Attention, andDMatTime1. Premeditation (thinkingbefore acting) was marginally higher among TRIP clients without attention difficulties. Perceived control over drug use decisions was lower in the TRIP group (among all males and among females without attention difficulties), suggesting greater personal insight into their ability to resist drug use in social situations. Conclusions: Findings suggest that TRIP promotes positive judgment and decision-making among adolescents, and that effectiveness varies by background characteristics such as gender and attention difficulties. Future studies should examine which specific elements of TRIP aremost relevant for improving decisionmaking and test explanatory models of how changes in judgment and decision-making affect treatment motivation, retention, and engagement. Financial support: NIDA R01DA013093. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.307 HIV/AIDS services in substance use disorder treatment programs within the clinical trials network Hannah K. Knudsen1, P.M. Roman2 1 University of Kentucky, Lexington, KY, United States 2 University of Georgia, Athens, GA, United States Aims: Previous research on HIV/AIDS-related services in substance use disorder (SUD) treatment has generally focused on the availability of HIV testing with less consideration of other prevention and supportive services. This study examines the adoption of HIV/AIDS-related services in treatment programs affiliated with NIDA’s Clinical Trials Network (CTN), with comparisons between opioid treatment programs (OTPs) and SUD treatment programs. Methods: Face-to-face interviews were conducted in 2011–2012 with administrators and clinical directors of 167 treatment programs that were members of NIDA’s CTN (response rate =79.9%). Dichotomous indicators measured whether programs: (1) conducted HIV risk assessments at treatment intake; (2) offered HIV education/prevention; (3) had adopted on-site HIV testing; (4) offered support groups for people with HIV/AIDS; and (5) provided on-site medical monitoring for people with HIV/AIDS (e.g., monitoring HAART compliance). Results: HIV risk assessment (86.2%) and HIV prevention/education (79.1%) were widely adopted by treatment programs in the CTN. About 54.7% of programs offered on-site HIV testing, consisting of 30.8% of programs using rapid HIV tests and another 23.9% using non-rapid tests. Fewer programs providedHIV support groups (22.9%) and medical monitoring for people with HIV/AIDS (24.8%). Opioid treatment programs were more likely than other SUD programs to offer on-site HIV testing (79.2% vs. 50.4%, p< .01) and support groups for people with HIV/AIDS (41.7% vs. 19.6%, p< .05). Conclusions: Although most treatment programs assess risk behaviors and offer HIV prevention/education, only half of the treatment programs within the NIDA CTN provide on-site HIV testing, which is a critical strategy for ensuring that patients receive their test results. Testing services have becomewidespread, however, within opioid treatment programs, which may reflect heightened concerns regarding the transmission of HIV/AIDS through injection drug use for their patient population. Financial support: Supported by the National Institute on Drug Abuse (R01DA14482). http://dx.doi.org/10.1016/j.drugalcdep.2014.02.308 Long-lasting sensitization induced by a single exposure to morphine: Age-related differences in mice

The effectiveness of the treatment retention and induction program (trip) for improving adolescent decision-making

s / Drug and Alcohol Dependence 140 (2014) e86–e168 e107 ment prior to implementation of TRIP (Standard Practice Group); 255 clients entered treatment after TRIP implementation began and received Standard enhanced by TRIP. ANCOVAs were used to examine Time 2 differences by TRIP, Gender, and Attention groups, controlling for demographic and judgment measures at Time 1. Results: Compared to Standard Practice, adolescents receiving TRIP scoredhigher onDecision-Making (DM), evenafter controlling for Gender, Drug use Severity, Age, Juvenile Justice Involvement, Attention, andDMatTime1. Premeditation (thinkingbefore acting) was marginally higher among TRIP clients without attention difficulties. Perceived control over drug use decisions was lower in the TRIP group (among all males and among females without attention difficulties), suggesting greater personal insight into their ability to resist drug use in social situations. Conclusions: Findings suggest that TRIP promotes positive judgment and decision-making among adolescents, and that effectiveness varies by background characteristics such as gender and attention difficulties. Future studies should examine which specific elements of TRIP aremost relevant for improving decisionmaking and test explanatory models of how changes in judgment and decision-making affect treatment motivation, retention, and engagement. Financial support: NIDA R01DA013093. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.307 HIV/AIDS services in substance use disorder treatment programs within the clinical trials network Hannah K. Knudsen1, P.M. Roman2 1 University of Kentucky, Lexington, KY, United States 2 University of Georgia, Athens, GA, United States Aims: Previous research on HIV/AIDS-related services in substance use disorder (SUD) treatment has generally focused on the availability of HIV testing with less consideration of other prevention and supportive services. This study examines the adoption of HIV/AIDS-related services in treatment programs affiliated with NIDA’s Clinical Trials Network (CTN), with comparisons between opioid treatment programs (OTPs) and SUD treatment programs. Methods: Face-to-face interviews were conducted in 2011–2012 with administrators and clinical directors of 167 treatment programs that were members of NIDA’s CTN (response rate =79.9%). Dichotomous indicators measured whether programs: (1) conducted HIV risk assessments at treatment intake; (2) offered HIV education/prevention; (3) had adopted on-site HIV testing; (4) offered support groups for people with HIV/AIDS; and (5) provided on-site medical monitoring for people with HIV/AIDS (e.g., monitoring HAART compliance). Results: HIV risk assessment (86.2%) and HIV prevention/education (79.1%) were widely adopted by treatment programs in the CTN. About 54.7% of programs offered on-site HIV testing, consisting of 30.8% of programs using rapid HIV tests and another 23.9% using non-rapid tests. Fewer programs providedHIV support groups (22.9%) and medical monitoring for people with HIV/AIDS (24.8%). Opioid treatment programs were more likely than other SUD programs to offer on-site HIV testing (79.2% vs. 50.4%, p< .01) and support groups for people with HIV/AIDS (41.7% vs. 19.6%, p< .05). Conclusions: Although most treatment programs assess risk behaviors and offer HIV prevention/education, only half of the treatment programs within the NIDA CTN provide on-site HIV testing, which is a critical strategy for ensuring that patients receive their test results. Testing services have becomewidespread, however, within opioid treatment programs, which may reflect heightened concerns regarding the transmission of HIV/AIDS through injection drug use for their patient population. Financial support: Supported by the National Institute on Drug Abuse (R01DA14482). http://dx.doi.org/10.1016/j.drugalcdep.2014.02.308 Long-lasting sensitization induced by a single exposure to morphine: Age-related differences in mice