Community-based Addiction Treatment Clinical Trials: HIV Rapid Testing and Counseling in Drug Abuse Treatment Practices

Drug abuse is a risk factor for HIV infection, and drug abuse clinics present an opportunity to perform rapid testing to identify early stages of the disease. Ensuring that those at risk know their HIV status is a major prevention strategy, and widespread testing is a major public health goal. The CDC recommends that rapid testing be done in all medical settings. To obviate burden and increase the liklihood of testing adoption, CDC recommends that HIV couseling is not necessary in these situations. Because of the opportunity to intervene in high risk patients is so great in drug abuse (DA) clinics, knowing the best approach to rapid HIV testing in those locations is essential. This trial demonstrated 3 approaches: onsite rapid testing with and without counseling and referral at the DA clinic, or testing off site. The trial enrolled 1,281 subjects in 12 outpatient DA community practices across the USA. The demographics of the enrolled subjects showed a representative mix: 39% were women, 21% African American and 11% Hispanic. Clear distinctions were discerned among the treatment conditions, and the lessons and approaches for drug abuse clinics will be discussed.