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Human Immunodeficiency Virus Testing Practices Among Buprenorphine-prescribing Physicians

Edelman, E. Jennifer MD; Dinh, An T. MD, MS; Moore, Brent A. PhD, MS; Schottenfeld, Richard S. MD; Fiellin, David A. MD; Sullivan, Lynn E. MD

Journal of Addiction Medicine: June 2012 - Volume 6 - Issue 2 - p 159–165
doi: 10.1097/ADM.0b013e31824339fc
Original Research

Background: Despite the Centers for Disease Control and Prevention recommendations for annual HIV testing of at-risk populations, including those with substance use disorders, there are no data on the human immunodeficiency virus (HIV) testing practices of buprenorphine-prescribing physicians.

Objective: To describe HIV testing practices among buprenorphine-prescribing physicians.

Methods: We conducted a cross-sectional survey of physicians enrolled in a national system to support buprenorphine prescribing between July and August 2008. The electronic survey included questions on demographics; clinical training and experience; clinical practice; patient characteristics; and physician screening practices, including HIV testing.

Results: Only 46% of 382 respondent physicians conducted HIV testing. On univariate analysis, physicians who conducted HIV testing were more likely to report addiction specialty training (33% vs 19%, P = 0.001), practicing in addiction settings (28% vs 16%, P = 0.006), and having treated more than 50 patients with buprenorphine (50% vs 31%, P < 0.0001) than those who did not. Compared with physicians who did not conduct HIV testing, physicians who conducted HIV testing had a lower proportion of buprenorphine patients who were white (75% vs 82%, P = 0.01) or dependent upon prescription opioids (57% vs 70%, P < 0.0001). In multivariate analysis, physicians who conducted HIV testing were more likely to have treated more than 50 patients with buprenorphine (odds ratio = 1.777, 95% CI 1.011-3.124) and had fewer patients dependent upon prescription opioids (odds ratio = 0.986 95% CI 0.975-0.998) than physicians who did not.

Conclusions: Interventions to increase HIV testing among physicians prescribing buprenorphine are needed.

From the Robert Wood Johnson Foundation Clinical Scholars Program (EJE), Yale University School of Medicine (EJE, ATD, BAM, RSS, DAF, LES), and Center for Interdisciplinary Research on AIDS (EJE, RSS, DAF, LES), Yale School of Public Health, New Haven, CT; and VA Connecticut Healthcare System (EJE), West Haven, CT.

Send correspondence and reprint requests to E. Jennifer Edelman, MD, Clinical Scholar's Program, Robert Wood Johnson Foundation, PO Box 208088, New Haven, CT 06520. Email: ejennifer.edelman@yale.edu.

Supported by Robert Wood Johnson Physician Faculty Scholars Award; NIDA grants (DA022398, DA000445, DA009803, DA019511-01, DA025991, and DA020576-01A1); Robert Wood Johnson Foundation Clinical Scholars Program and the US Department of Veterans Affairs Administration. These funding sources had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

Presented in earlier version at the College on Problems of Drug Dependence Annual Meeting, June 24, 2009, Reno, Nevada.

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

The authors have no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (www.journaladdictionmedicine.com).

Received June 18, 2011

Accepted June 21, 2011

© 2012 American Society of Addiction Medicine