Impact of State HIV and Hepatitis C (HCV) Screening Policies on HIV/HCV Testing Provision at Substance Use Disorder (SUD) Treatment Programs in The United States

Author: Czarina Behrends Grace Corry Jemima Frimpong

Theme: Social Science & Policy Research Year: 2022

HIV and HCV testing at substance use disorder (SUD) treatment programs is cost-effective, but few
SUD treatment programs in the United States provide any testing. Little is known about state policy
requirements or recommendations for HIV/HCV testing and whether programs are compliant.
We examined state SUD treatment policies for information on HIV/HCV testing. We categorized
state-level HIV and HCV testing policies as required, recommended, or no information. We linked
this data to the 2017 National Drug Abuse Treatment System Survey, a nationally representative
sample of U.S. SUD treatment programs and their operating characteristics (N=1352). We describe
state policies for HIV/HCV testing at SUD treatment programs then conducted univariable (chisquare tests and t-tests) and multivariable (logistic regression) analyses to assess associations
between these policies (required/recommended vs. no information) and organizational
characteristics with testing practice (on-site/referral testing vs. none; onsite vs. not onsite).
In the US, 73% of states required or recommended HIV testing and 48% required or recommended
HCV testing at SUD treatment programs. While 75% of states require/recommend HIV testing, SUD
treatment programs in these States are less likely to offer any HIV testing (onsite or referral) than
programs located in states without an HIV testing policy (41.1 and 49.6; p-value <0.05); this
remained true in multivariate logistic regression. In states with any HCV testing policies, programs
offer more testing (48.9% vs. 40.3%; p-value<0.05) than their counterparts. There were no
significant differences in the offering of on-site HIV or HCV testing between programs with
compared to those without any testing policies.
Despite most states requiring or recommending HIV testing by SUD treatment programs, programs
are largely not complying with state policy. Early implementation of HIV policies may have resulted
in reduced compliance over time, which needs to be explored in future research.
Disclosure of Interest Statement:
We have no conflicts of interest to disclose.

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