The Johns Hopkins Carey Business School, Baltimore, MD.
Columbia University Mailman School of Public Health.
Med Care. 2020 May;58(5):445-452. doi: 10.1097/MLR.0000000000001311.
The overlapping human immunodeficiency virus (HIV) and hepatitis C virus (HCV) epidemics disproportionately affect people with substance use disorders. However, many people who use substances remain unaware of their infection(s).
The objective of this study was to examine the efficacy of an on-site bundled rapid HIV and HCV testing strategy in increasing receipt of both HIV and HCV test results.
Two-armed randomized controlled trial in substance use disorder treatment programs (SUDTP) in New York City. Participants in the treatment arm were offered bundled rapid HIV and HCV tests with immediate results on-site. Participants in the control arm were offered the standard of care, that is, referrals to on-site or off-site laboratory-based HIV and HCV testing with delayed results.
A total of 162 clients with unknown or negative HIV and HCV status.
The primary outcome was the percentage of participants with self-reported receipt of HIV and HCV test results at 1-month postrandomization.
Over half of participants were Hispanic (51.2%), with 25.3% being non-Hispanic black and 17.9% non-Hispanic white. Two thirds were male, and 54.9% reported injection as method of drug use. One hundred thirty-four participants (82.7%) completed the 1-month assessment. Participants in the treatment arm were more likely to report having received both test results than those in the control arm (69% vs. 19%, P<0.001). Seven participants in the treatment arm received a preliminary new HCV diagnosis, versus 1 in the control arm (P=0.029).
Offering bundled rapid HIV and HCV testing with immediate results on-site in SUDTPs may increase awareness of HIV and HCV infection among people with substance use disorders.
重叠的人类免疫缺陷病毒 (HIV) 和丙型肝炎病毒 (HCV) 流行对患有物质使用障碍的人产生了不成比例的影响。然而,许多使用物质的人仍然不知道自己是否感染了病毒。
本研究旨在检验现场捆绑式快速 HIV 和 HCV 检测策略对提高 HIV 和 HCV 检测结果的获取率的效果。
在纽约市的物质使用障碍治疗计划 (SUDTP) 中进行的双臂随机对照试验。治疗组的参与者接受现场捆绑式快速 HIV 和 HCV 检测,并立即获得检测结果。对照组的参与者接受标准护理,即提供现场或场外基于实验室的 HIV 和 HCV 检测转介,结果延迟获得。
共有 162 名 HIV 和 HCV 检测结果未知或阴性的患者。
主要结果是在随机分组后 1 个月内报告收到 HIV 和 HCV 检测结果的参与者比例。
超过一半的参与者为西班牙裔 (51.2%),25.3%为非西班牙裔黑人,17.9%为非西班牙裔白人。三分之二为男性,54.9%的人报告使用注射方式使用毒品。134 名参与者 (82.7%)完成了 1 个月的评估。与对照组相比,治疗组更有可能报告收到了两项检测结果 (69% 对 19%,P<0.001)。治疗组有 7 名参与者收到了初步的新 HCV 诊断,而对照组只有 1 名 (P=0.029)。
在 SUDTP 中提供现场捆绑式快速 HIV 和 HCV 检测并立即获得结果,可能会提高患有物质使用障碍的人对 HIV 和 HCV 感染的认识。