January 2, 2014
This article was reported by Medpage Today.
Medpage Today reported on a study of opioid treatment programs that offer addicts onsite testing for HIV, STDs, and hepatitis C virus (HCV) infection. Marcus Bachuber, MD, and Chinazo Cunningham, MD, of New York City's Albert Einstein College of Medicine reasoned that opioid addiction is an accepted risk factor for HIV, STDs and HCV, and that opioid treatment centers are uniquely convenient places to provide testing for these diseases. The researchers hypothesized that the proportion of treatment facilities offering such testing increased after the 2006 CDC recommendation for routine HIV testing in healthcare settings.
The researchers analyzed National Survey of Substance Abuse Treatment Services data from the Substance Abuse and Mental Health Services Administration in Rockville, Md. Directors of drug treatment facilities who received the survey had a 96.5-percent response rate. The researchers reviewed data from 2000 and 2002 to 2011. During the 12 years, the number of treatment programs increased from 849 in 2000 to 1,175 in 2011. The number of for-profit centers increased from 43 percent to 54 percent during this period while public programs decreased from 14 percent to 10 percent and nonprofits decreased from 43 percent to 36 percent.
The percentage of programs offering HIV and STD testing dropped by 18 percent and 13 percent, respectively, while there was no significant change in the percentage offering HCV testing. No significant change occurred during this time in the public programs offering onsite testing for each infection. HIV testing decreased 20 percent in for-profit programs and 11 percent in nonprofits. Also, onsite testing for STDs decreased 23 percent in for-profit programs but did not change in nonprofits. HCV testing decreased 13 percent in for-profit programs and rose 14 percent among nonprofits.
The researchers concluded that patients in for-profit programs may be at risk for delayed diagnoses and continued disease transmission.
The full report, "Changes in Testing for Human Immunodeficiency Virus, Sexually Transmitted Infections, and Hepatitis C Virus in Opioid Treatment Programs," was published in the Journal of the American Medical Association (2013; 310(24):26712672).