# A Cluster RCT to Increase HIV Testing in Substance Use Treatment Programs

> **NIH NIH R01** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2021 · $1,188,364

## Abstract

Project Summary/Abstract
Approximately one in eight people living with HIV in the US are unaware of their infection and the majority of
adults in the US have never been HIV tested. The CDC and WHO have called for expanding HIV testing in
settings where high-risk persons receive health services, including opioid treatment programs (OTPs).
Persons who use opioids and other substances have high HIV risk compared with the general population; yet
fewer than half of US substance use disorder (SUD) treatment programs offer on-site HIV testing and the
proportion of OTPs that do has declined in the past decade. There is widespread recognition of the need for
increased HIV testing and the effectiveness and economic value of on-site HIV testing in SUD treatment
programs has been demonstrated. Recent recommendations from the US Preventive Services Task Force
(USPSTF) that adolescents and adults should be screened for HIV in health care settings provide new
opportunities for expanding access to HIV testing in OTPs. To optimize this opportunity, OTPs must address
and overcome organizational-level barriers to testing, including staffing, training, concerns about delivering HIV
test results and linkage to care, and the need to set up systems to support reimbursement for HIV testing
services. Additionally, Hepatitis C (HCV) testing is perceived as an even greater need by some SUD
programs. HCV prevalence, high among opioid users, is higher than HIV prevalence and more individuals with
chronic HCV infection are unaware of their infection. Thus, we will examine whether the offer of HCV testing
with HIV testing would be a motivator for adoption and implementation of HIV testing. Within this context, a 3-
arm cluster-RCT of 51 OTPs will be used to test 2 active evidence-based “practice coaching” (PC)
interventions to improve the provision and sustained implementation of 1) HIV testing and linkage to care and
2) joint HIV/HCV testing and linkage to care among OTP patients. In PC, change agents and key OTP staff are
provided training and support to facilitate the implementation of innovation and sustain resulting improvements.
Specific aims are: Aim 1: To evaluate the effectiveness of the PC interventions on improving patient uptake of
HIV testing in OTPs including the incremental impact of the HIV/HCV intervention on HIV testing. Aim 2: To
examine, using mixed-methods, the impact of the PC interventions on the initiation and sustained provision of
HIV testing and timely linkage to care. Aim 3: To evaluate the health outcomes, health care utilization, and
cost-effectiveness of the PC interventions compared incrementally to one another and to the control condition.
This will be the first study to test organizational approaches to increase HIV and HIV/HCV testing and linkage
to care among patients in OTPs. This proposal is aligned with the new NIH-wide priorities for HIV/AIDS
research. The first priority is to reduce HIV/AIDS incidence and one of the main points is to de...

## Key facts

- **NIH application ID:** 9993488
- **Project number:** 5R01DA043130-05
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Daniel J Feaster
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $1,188,364
- **Award type:** 5
- **Project period:** 2016-09-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9993488

## Citation

> US National Institutes of Health, RePORTER application 9993488, A Cluster RCT to Increase HIV Testing in Substance Use Treatment Programs (5R01DA043130-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9993488. Licensed CC0.

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