The Association Between Receiving Medications for Opioid Use Disorder and Human Immunodeficiency Virus Testing:...

Injection drug use is associated with increased risk of blood-borne infectious disease transmission. People with opioid use disorder (OUD) may be less likely to receive health care services, including human immunodeficiency virus (HIV screening), especially in rural areas. Addiction treatment settings may provide additional opportunities to screen for HIV in this population.

The rural opioid initiative (ROI) conducted a survey of people who use drugs (PWUD) on substance use, health care access, and utilization. From January 2018 to March 2020, PWUD were enrolled across 65 rural counties in 10 US states. Eligible participants either used opioids or reported injecting any drug "to get high" in the past 30 days. We evaluated the association between reporting past 30-day medication for OUD (MOUD) receipt and past-year HIV testing using relative risk regression.

Participants (N = 2649, mean age = 36 y) were predominantly male (57%), reporting White race (85%) and non-Hispanic ethnicity (96%). Among participants receiving MOUD (methadone or buprenorphine) in the past year, 42% (179/431) were HIV-tested in the past year compared with 29% (636/2,218) among those not receiving MOUD. The prevalence of HIV testing in the past year was 1.42 times greater when comparing those who received MOUD in the past 30 days compared with those who did not (95% CI: 1.25-1.62).

Recent HIV testing prevalence among this rural population of PWUD was low, given testing guidelines. Future research should explore ways to increase testing in rural drug treatment settings and whether there are differences by treatment setting type.