Correlates of Recent HIV Testing Among People Who Inject Drugs in Rural Areas: A Multi-site Cross-Sectional Study, 2018–2020

Umedjon Ibragimov; Melvin D. Livingston; April M. Young; Judith Feinberg; P. Todd Korthuis; Wajiha Z. Akhtar; Wiley D. Jenkins; Heidi M. Crane; Ryan P. Westergaard; Robin Nance; William C. Miller; John Bresett; Dalia Khoury; Christopher B. Hurt; Vivian F. Go; Kerry Nolte; Hannah L.F. Cooper

doi:10.1007/s10461-023-04140-x

Correlates of Recent HIV Testing Among People Who Inject Drugs in Rural Areas: A Multi-site Cross-Sectional Study, 2018–2020

Umedjon Ibragimov, Melvin D. Livingston, April M. Young, Judith Feinberg, P. Todd Korthuis, Wajiha Z. Akhtar, Wiley D. Jenkins, Heidi M. Crane, Ryan P. Westergaard, Robin Nance, William C. Miller, John Bresett, Dalia Khoury, Christopher B. Hurt, Vivian F. Go, Kerry Nolte, Hannah L.F. Cooper

Research output: Contribution to journal › Article › peer-review

Abstract

The Rural Opioid Initiative surveyed 2693 people who inject drugs (PWID) in eight rural U.S. areas in 2018–2020 about self-reported HIV testing in the past 6 months. Correlates of interest included receipt of any drug-related services, incarceration history, and structural barriers to care (e.g., lack of insurance, proximity to syringe service programs [SSP]). Overall, 20% of participants reported receiving an HIV test within the past 6 months. Multivariable generalized estimating equations showed that attending substance use disorder (SUD) treatment (OR 2.11, 95%CI [1.58, 2.82]), having health insurance (OR 1.42, 95%CI [1.01, 2.00]) and recent incarceration (OR 1.49, 95%CI [1.08, 2.04]) were positively associated with HIV testing, while experiencing a resource barrier to healthcare (inability to pay, lack of transportation, inconvenient hours, or lack of child care) had inverse (OR 0.73, 95%CI [0.56, 0.94]) association with HIV testing. We found that the prevalence of HIV testing among rural PWID is low, indicating an unmet need for testing. While SUD treatment or incarceration may increase chances for HIV testing for rural PWID, other avenues for expanding HIV testing, such as SSP, need to be explored.

Original language	English
Pages (from-to)	59-71
Number of pages	13
Journal	AIDS and Behavior
Volume	28
Issue number	1
DOIs	https://doi.org/10.1007/s10461-023-04140-x
State	Published - Jan 2024

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Funding

This work was supported by the National Institute on Drug Abuse [UG3DA044829/UH3DA044829, UG3DA044798/UH3DA044798, UG3DA044830/UH3DA044830, UG3DA044823/UH3DA044823, UG3DA044822/UH3DA044822, UG3DA044831/UH3DA044831, UG3DA044825, UG3DA044826/UH3DA044826] with co-funding from the Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health Services Administration (SAMHSA), and the Appalachian Regional Commission (ARC). This publication is based upon data collected and/or methods developed as part of the Rural Opioid Initiative (ROI), a multi-site study with a common protocol that was developed collaboratively by investigators at eight research institutions and at the National Institute of Drug Abuse (NIDA), the Appalachian Regional Commission (ARC), the Centers for Disease Control and Prevention (CDC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). The views and opinions expressed in this manuscript are those of the authors only and do not necessarily represent the views, official policy or position of the U.S. Department of Health and Human Services or any of its affiliated institutions or agencies, or those of the Appalachian Regional Commission. The authors thank the other ROI investigators and their teams, community and state partners, and the participants of the individual ROI studies for their valuable contributions. We analyzed cross-sectional (baseline) data from the multisite Rural Opioid Initiative (ROI) study, jointly funded by the National Institute on Drug Abuse, the CDC, the Substance Abuse and Mental Health Services Administration, and the Appalachian Regional Commission to investigate patterns and correlates of drug-related harms in rural areas. The ROI survey engaged eight rural areas: Ohio (3 counties), North Carolina (8 counties), Kentucky (5 counties), Oregon (2 counties), Illinois (16 counties), Wisconsin (6 counties), West Virginia (7 counties), and New England (10 counties in Massachusetts, New Hampshire, and Vermont). Eligible participants had to live in one of these rural areas, self-report the use of any opioid “to get high” (e.g., heroin, prescription pain medication, etc.) or drug injection in the previous 30 days, and be at least 18 years of age. Additional eligibility criteria were tailored slightly to meet region-specific needs []. For this analysis, we limited the study sample to those who reported any drug injection in the past 12 months (n = 2693, or 97% of the total sample).

Funders	Funder number
Rural Opioid Initiative
U.S. Department of Health and Human Services
National Institute on Drug Abuse	UG3DA044829/UH3DA044829, UG3DA044798/UH3DA044798, UG3DA044826/UH3DA044826, UG3DA044823/UH3DA044823, UG3DA044831/UH3DA044831, UG3DA044822/UH3DA044822, UG3DA044830/UH3DA044830, UG3DA044825
National Institute on Drug Abuse
Centers for Disease Control and Prevention
Substance Abuse and Mental Health Services Administration
Appalachian Regional Commission

Keywords

Barriers to services
HIV testing
PWID
Rural

ASJC Scopus subject areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/s10461-023-04140-x

Cite this

Ibragimov, U., Livingston, M. D., Young, A. M., Feinberg, J., Korthuis, P. T., Akhtar, W. Z., Jenkins, W. D., Crane, H. M., Westergaard, R. P., Nance, R., Miller, W. C., Bresett, J., Khoury, D., Hurt, C. B., Go, V. F., Nolte, K., & Cooper, H. L. F. (2024). Correlates of Recent HIV Testing Among People Who Inject Drugs in Rural Areas: A Multi-site Cross-Sectional Study, 2018–2020. AIDS and Behavior, 28(1), 59-71. https://doi.org/10.1007/s10461-023-04140-x

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title = "Correlates of Recent HIV Testing Among People Who Inject Drugs in Rural Areas: A Multi-site Cross-Sectional Study, 2018–2020",

abstract = "The Rural Opioid Initiative surveyed 2693 people who inject drugs (PWID) in eight rural U.S. areas in 2018–2020 about self-reported HIV testing in the past 6 months. Correlates of interest included receipt of any drug-related services, incarceration history, and structural barriers to care (e.g., lack of insurance, proximity to syringe service programs [SSP]). Overall, 20% of participants reported receiving an HIV test within the past 6 months. Multivariable generalized estimating equations showed that attending substance use disorder (SUD) treatment (OR 2.11, 95%CI [1.58, 2.82]), having health insurance (OR 1.42, 95%CI [1.01, 2.00]) and recent incarceration (OR 1.49, 95%CI [1.08, 2.04]) were positively associated with HIV testing, while experiencing a resource barrier to healthcare (inability to pay, lack of transportation, inconvenient hours, or lack of child care) had inverse (OR 0.73, 95%CI [0.56, 0.94]) association with HIV testing. We found that the prevalence of HIV testing among rural PWID is low, indicating an unmet need for testing. While SUD treatment or incarceration may increase chances for HIV testing for rural PWID, other avenues for expanding HIV testing, such as SSP, need to be explored.",

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note = "Publisher Copyright: {\textcopyright} 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

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doi = "10.1007/s10461-023-04140-x",

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Ibragimov, U, Livingston, MD, Young, AM, Feinberg, J, Korthuis, PT, Akhtar, WZ, Jenkins, WD, Crane, HM, Westergaard, RP, Nance, R, Miller, WC, Bresett, J, Khoury, D, Hurt, CB, Go, VF, Nolte, K & Cooper, HLF 2024, 'Correlates of Recent HIV Testing Among People Who Inject Drugs in Rural Areas: A Multi-site Cross-Sectional Study, 2018–2020', AIDS and Behavior, vol. 28, no. 1, pp. 59-71. https://doi.org/10.1007/s10461-023-04140-x

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AU - Feinberg, Judith

AU - Korthuis, P. Todd

AU - Akhtar, Wajiha Z.

AU - Jenkins, Wiley D.

AU - Crane, Heidi M.

AU - Westergaard, Ryan P.

AU - Nance, Robin

AU - Miller, William C.

AU - Bresett, John

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Correlates of Recent HIV Testing Among People Who Inject Drugs in Rural Areas: A Multi-site Cross-Sectional Study, 2018–2020

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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