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Objectives. We examined trends and organizational-level correlates of the availability of HCV testing in opioid treatment programs.
Methods. We used generalized ordered logit models to examine associations between organizational characteristics of 383 opioid treatment programs from the 2005 and 2011 National Drug Abuse Treatment System Survey and HCV testing availability.
Results. Between 2005 and 2011, the proportion of opioid treatment programs offering HCV testing increased but largely because of increases in off-site referrals rather than on-site testing. HCV testing availability was higher in opioid treatment programs affiliated with a hospital and those receiving federal funds. Opioid treatment programs providing both methadone and buprenorphine were more likely to offer any HCV testing, whereas opioid treatment programs providing only buprenorphine treatment were less likely to offer on-site testing. HCV testing availability was associated with more favorable staff-to-client ratios.
Conclusions. The increasing use of off-site referrals for HCV testing in opioid treatment programs likely limits opportunities for case finding, prevention, and treatment. Declines in federal funding for opioid treatment programs may be a key determinant of the availability of HCV testing in opioid treatment programs. (Am J Public Health. 2014;104:e75-e82. doi:10.2105/AJPH.2013.301827)
HCV is the most common blood-borne infection in the United States. An estimated 3.2 million people in the United States are chronically infectedwithHCV,1makingit3 to5timesmore frequent than HIV.2 Results from a recent study showed that HCV has surpassed HIV as a cause of death in the United States.3 New HCV treatment regimens that are more effective and have fewer side effects have recently become available.4 Unfortunately, fewer than half of the patients living with HCV are aware of their infection.5 This is because infected persons tend to be asymptomatic: in some cases, signs of the disease do not manifest for decades.6 It is thus important to encourage and offer extensive opportunities for HCV testing, especially to the most at-risk populations.6
Advancements in testing technologies (HCV rapid testing)7 and recommendations for the identification of HCV in the general population (i.e., individuals born between 1945 and 1965) present opportunities for increasing the avail- ability of HCV testing.8 Testing could foster increased case finding, as well as earlier linkages to HCV care and treatment services. Ensuring access to HCV testing and increasing awareness of HCV status also could help promote...