215811 Determinants of the availability of HIV testing services in substance abuse treatment facilities in the United States, 2007

Monday, November 8, 2010 : 8:45 AM - 9:00 AM

Mesfin S. Mulatu, PhD, MPH , Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Dionne C. Godette, PhD , Department of Health Promotion & Behavior, University of Georgia, College of Public Health, Athens, GA
Kimberly R. Thomas, MPH, CHES , Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
Shubha Rao, MD, MPH , Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
     
Background: Risk behaviors associated with substance abuse are contributing factors to the spread of HIV infection. Provision of HIV testing services to substance abuse treatment (SAT) clients is an important component of a comprehensive national HIV prevention program. This study examines the extent and determinants of the availability of HIV testing in SAT facilities.

Methods: Data from the 2007 National Survey of Substance Abuse Treatment Services – a survey of SAT facilities in the U.S. (n = 13,648) – were analyzed. Multivariate logistic regression analysis was applied to examine the relationships between HIV testing availability and several facility attributes (e.g., ownership, hospital affiliation, accreditation).

Results: Only 29.7% of the SAT facilities offered HIV testing. HIV testing was more likely to be offered in government (OR=2.20, 95% CI=1.83–2.64) and private non-profit (OR=1.32, 95% CI=1.15–1.52) than in private for-profit facilities. Availability of HIV testing was also higher in facilities affiliated with hospitals (OR=1.72, 95% CI=1.45–2.04), accredited (OR=2.17, 95% CI=1.95–2.41), and that provided detoxification (OR=2.74, 95% CI=2.44–3.07) than facilities without these attributes. In contrast, facilities with managed care contracts (OR=.86, 95% CI=.77–.96) and outpatient services (OR=0.64, 95% CI=.55–.76) were less likely to offer HIV testing compared to those without these attributes.

Conclusions: HIV testing services are not widely available in SAT facilities, implying significant missed opportunities for HIV prevention among SAT clients. Strong links between facility characteristics and HIV testing availability suggest the necessity to expand HIV prevention capacity that fits the needs and resources of SAT facilities.

Learning Areas:
Administer health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Determine the extent of HIV testing services offered in substance abuse treatment facilities in the United States Identify the facility characteristics that are associated with the offering of HIV testing services in substance abuse treatment facilities in the United States Discuss the implications of the findings to the expansion of HIV testing services in substance abuse treatment facilities in the United States

Keywords: HIV Interventions, Substance Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a behavioral scientist with several years of research experience in HIV/AIDS and substance abuse related issues. I also led the conceptualization of the study as well as the data analysis.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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