Prevalence of Testing for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Among Medicaid Enrollees Treated With Medications for Opioid Use Disorder in 11 States, 2016-2019

doi:10.1093/cid/ciac981

Prevalence of Testing for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Among Medicaid Enrollees Treated With Medications for Opioid Use Disorder in 11 States, 2016-2019

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

Abstract

Background. Limited information exists about testing for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among Medicaid enrollees after starting medication for opioid use disorder (MOUD), despite guidelines recommending such testing. Our objectives were to estimate testing prevalence and trends for HIV, HBV, and HCV among Medicaid enrollees initiating MOUD and examine enrollee characteristics associated with testing. Methods. We conducted a serial cross-sectional study of 505 440 initiations of MOUD from 2016 to 2019 among 361 537 Medicaid enrollees in 11 states. Measures of MOUD initiation; HIV, HBV, and HCV testing; comorbidities; and demographics were based on enrollment and claims data. Each state used Poisson regression to estimate associations between enrollee characteristics and testing prevalence within 90 days of MOUD initiation. We pooled state-level estimates to generate global estimates using random effects meta-analyses. Results. From 2016 to 2019, testing increased from 20% to 25% for HIV, from 22% to 25% for HBV, from 24% to 27% for HCV, and from 15% to 19% for all 3 conditions. Adjusted rates of testing for all 3 conditions were lower among enrollees who were male (vs nonpregnant females), living in a rural area (vs urban area), and initiating methadone or naltrexone (vs buprenorphine). Associations between enrollee characteristics and testing varied across states. Conclusions. Among Medicaid enrollees in 11 US states who initiated medications for opioid use disorder, testing for human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and all 3 conditions increased between 2016 and 2019 but the majority were not tested.

Original language	English
Pages (from-to)	1793-1801
Number of pages	9
Journal	Clinical Infectious Diseases
Volume	76
Issue number	10
DOIs	https://doi.org/10.1093/cid/ciac981
State	Published - May 15 2023

Bibliographical note

Funding Information:
The National Institute for Drug Abuse (R01DA048029) funded this project. J. M. D., L. A., A. E. A., M. E. B., A. J. G., S. M., M. S., and K. Z. report receiving funds from NIDA during the conduct of the study. J. M. D. and M. S. receive salary support from the Pennsylvania Department of Human Services for work unrelated to the project. S. M. reports support from a National Institutes of Health grant, University of Pittsburgh (PTE federal award, 1R01DA048029-01; subrecipient, University of Maryland-Baltimore subaward AWD00000068 [132578-3]). A. J. G. reports being an uncompensated board of directors member for the American Society of Addiction Medicine and the Association for Multidisciplinary Education and Research in Substance Use and Addiction and receives renumerations from UpToDate. K. A. reports a Maine Department of Health cooperative agreement during the conduct of the study. M. J. M. reports grants from the Delaware Division of Medicaid and Medical Assistance during the conduct of the study and from the University of Delaware, Center for Community Research & Service (funding for 50% of the project). L. A. reports support for attending meetings and/or travel (made to institutions). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Funding Information:
Financial support . The National Institute for Drug Abuse (R01DA048029) funded this project. J. M. D., L. A., A. E. A., M. E. B., A. J. G., S. M., M. S., and K. Z. report receiving funds from NIDA during the conduct of the study. J. M. D. and M. S. receive salary support from the Pennsylvania Department of Human Services for work unrelated to the project. S. M. reports support from a National Institutes of Health grant, University of Pittsburgh (PTE federal award, 1R01DA048029–01; subrecipient, University of Maryland–Baltimore subaward AWD00000068 [132578-3]). A. J. G. reports being an uncompensated board of directors member for the American Society of Addiction Medicine and the Association for Multidisciplinary Education and Research in Substance Use and Addiction and receives renumerations from UpToDate. K. A. reports a Maine Department of Health cooperative agreement during the conduct of the study. M. J. M. reports grants from the Delaware Division of Medicaid and Medical Assistance during the conduct of the study and from the University of Delaware, Center for Community Research & Service (funding for 50% of the project). L. A. reports support for attending meetings and/or travel (made to institutions). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Publisher Copyright:
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved.

Keywords

HIV
Medicaid
hepatitis
opioid use disorder
testing

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

UN SDGs

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

Access to Document

10.1093/cid/ciac981

Cite this

@article{00b5c0a03a224a9595ea341e3f1d195d,

title = "Prevalence of Testing for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Among Medicaid Enrollees Treated With Medications for Opioid Use Disorder in 11 States, 2016-2019",

abstract = "Background. Limited information exists about testing for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among Medicaid enrollees after starting medication for opioid use disorder (MOUD), despite guidelines recommending such testing. Our objectives were to estimate testing prevalence and trends for HIV, HBV, and HCV among Medicaid enrollees initiating MOUD and examine enrollee characteristics associated with testing. Methods. We conducted a serial cross-sectional study of 505 440 initiations of MOUD from 2016 to 2019 among 361 537 Medicaid enrollees in 11 states. Measures of MOUD initiation; HIV, HBV, and HCV testing; comorbidities; and demographics were based on enrollment and claims data. Each state used Poisson regression to estimate associations between enrollee characteristics and testing prevalence within 90 days of MOUD initiation. We pooled state-level estimates to generate global estimates using random effects meta-analyses. Results. From 2016 to 2019, testing increased from 20% to 25% for HIV, from 22% to 25% for HBV, from 24% to 27% for HCV, and from 15% to 19% for all 3 conditions. Adjusted rates of testing for all 3 conditions were lower among enrollees who were male (vs nonpregnant females), living in a rural area (vs urban area), and initiating methadone or naltrexone (vs buprenorphine). Associations between enrollee characteristics and testing varied across states. Conclusions. Among Medicaid enrollees in 11 US states who initiated medications for opioid use disorder, testing for human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and all 3 conditions increased between 2016 and 2019 but the majority were not tested.",

keywords = "HIV, Medicaid, hepatitis, opioid use disorder, testing",

author = "Katherine Ahrens and Michael Sharbaugh and Jarlenski, {Marian P.} and Lu Tang and Lindsay Allen and Austin, {Anna E.} and Barnes, {Andrew J.} and Burns, {Marguerite E.} and Sarah Clark and Kara Zivin and Aimee Mack and Gilbert Liu and Shamis Mohamoud and McDuffie, {Mary Joan} and Lindsey Hammerslag and Gordon, {Adam J.} and Donohue, {Julie M.} and David Kelley and {Everette James}, A. and Monica Costlow and Lisa Cohn and Marie LaPres and Lauryn Walker and Ashley Harrell and Kristen Voskuil and Steve Tyska and Cynthia Parsons and James Becker and Yilin Cai and Alyssa Brown and Alice Middleton and Cynthia Woodcock and Elizabeth Brown and Dara Hall and Roderick Rose and Emma Sandoe and Shannon Dowler and Catherine McGuire and David Jorgenson and Maik Schutze and Angela Taylor and Jeff Talbert and Mary Applegate and Kendallyn Markman and Mark Rizzutti and Elizabeth Truex-Powell and Robert Ashmead and Emelie Bailey",

note = "Funding Information: The National Institute for Drug Abuse (R01DA048029) funded this project. J. M. D., L. A., A. E. A., M. E. B., A. J. G., S. M., M. S., and K. Z. report receiving funds from NIDA during the conduct of the study. J. M. D. and M. S. receive salary support from the Pennsylvania Department of Human Services for work unrelated to the project. S. M. reports support from a National Institutes of Health grant, University of Pittsburgh (PTE federal award, 1R01DA048029-01; subrecipient, University of Maryland-Baltimore subaward AWD00000068 [132578-3]). A. J. G. reports being an uncompensated board of directors member for the American Society of Addiction Medicine and the Association for Multidisciplinary Education and Research in Substance Use and Addiction and receives renumerations from UpToDate. K. A. reports a Maine Department of Health cooperative agreement during the conduct of the study. M. J. M. reports grants from the Delaware Division of Medicaid and Medical Assistance during the conduct of the study and from the University of Delaware, Center for Community Research & Service (funding for 50% of the project). L. A. reports support for attending meetings and/or travel (made to institutions). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Funding Information: Financial support . The National Institute for Drug Abuse (R01DA048029) funded this project. J. M. D., L. A., A. E. A., M. E. B., A. J. G., S. M., M. S., and K. Z. report receiving funds from NIDA during the conduct of the study. J. M. D. and M. S. receive salary support from the Pennsylvania Department of Human Services for work unrelated to the project. S. M. reports support from a National Institutes of Health grant, University of Pittsburgh (PTE federal award, 1R01DA048029–01; subrecipient, University of Maryland–Baltimore subaward AWD00000068 [132578-3]). A. J. G. reports being an uncompensated board of directors member for the American Society of Addiction Medicine and the Association for Multidisciplinary Education and Research in Substance Use and Addiction and receives renumerations from UpToDate. K. A. reports a Maine Department of Health cooperative agreement during the conduct of the study. M. J. M. reports grants from the Delaware Division of Medicaid and Medical Assistance during the conduct of the study and from the University of Delaware, Center for Community Research & Service (funding for 50% of the project). L. A. reports support for attending meetings and/or travel (made to institutions). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Publisher Copyright: {\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved.",

year = "2023",

month = may,

day = "15",

doi = "10.1093/cid/ciac981",

language = "English",

volume = "76",

pages = "1793--1801",

number = "10",

}

TY - JOUR

T1 - Prevalence of Testing for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Among Medicaid Enrollees Treated With Medications for Opioid Use Disorder in 11 States, 2016-2019

AU - Ahrens, Katherine

AU - Sharbaugh, Michael

AU - Jarlenski, Marian P.

AU - Tang, Lu

AU - Allen, Lindsay

AU - Austin, Anna E.

AU - Barnes, Andrew J.

AU - Burns, Marguerite E.

AU - Clark, Sarah

AU - Zivin, Kara

AU - Mack, Aimee

AU - Liu, Gilbert

AU - Mohamoud, Shamis

AU - McDuffie, Mary Joan

AU - Hammerslag, Lindsey

AU - Gordon, Adam J.

AU - Donohue, Julie M.

AU - Kelley, David

AU - Everette James, A.

AU - Costlow, Monica

AU - Cohn, Lisa

AU - LaPres, Marie

AU - Walker, Lauryn

AU - Harrell, Ashley

AU - Voskuil, Kristen

AU - Tyska, Steve

AU - Parsons, Cynthia

AU - Becker, James

AU - Cai, Yilin

AU - Brown, Alyssa

AU - Middleton, Alice

AU - Woodcock, Cynthia

AU - Brown, Elizabeth

AU - Hall, Dara

AU - Rose, Roderick

AU - Sandoe, Emma

AU - Dowler, Shannon

AU - McGuire, Catherine

AU - Jorgenson, David

AU - Schutze, Maik

AU - Taylor, Angela

AU - Talbert, Jeff

AU - Applegate, Mary

AU - Markman, Kendallyn

AU - Rizzutti, Mark

AU - Truex-Powell, Elizabeth

AU - Ashmead, Robert

AU - Bailey, Emelie

N1 - Funding Information: The National Institute for Drug Abuse (R01DA048029) funded this project. J. M. D., L. A., A. E. A., M. E. B., A. J. G., S. M., M. S., and K. Z. report receiving funds from NIDA during the conduct of the study. J. M. D. and M. S. receive salary support from the Pennsylvania Department of Human Services for work unrelated to the project. S. M. reports support from a National Institutes of Health grant, University of Pittsburgh (PTE federal award, 1R01DA048029-01; subrecipient, University of Maryland-Baltimore subaward AWD00000068 [132578-3]). A. J. G. reports being an uncompensated board of directors member for the American Society of Addiction Medicine and the Association for Multidisciplinary Education and Research in Substance Use and Addiction and receives renumerations from UpToDate. K. A. reports a Maine Department of Health cooperative agreement during the conduct of the study. M. J. M. reports grants from the Delaware Division of Medicaid and Medical Assistance during the conduct of the study and from the University of Delaware, Center for Community Research & Service (funding for 50% of the project). L. A. reports support for attending meetings and/or travel (made to institutions). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Funding Information: Financial support . The National Institute for Drug Abuse (R01DA048029) funded this project. J. M. D., L. A., A. E. A., M. E. B., A. J. G., S. M., M. S., and K. Z. report receiving funds from NIDA during the conduct of the study. J. M. D. and M. S. receive salary support from the Pennsylvania Department of Human Services for work unrelated to the project. S. M. reports support from a National Institutes of Health grant, University of Pittsburgh (PTE federal award, 1R01DA048029–01; subrecipient, University of Maryland–Baltimore subaward AWD00000068 [132578-3]). A. J. G. reports being an uncompensated board of directors member for the American Society of Addiction Medicine and the Association for Multidisciplinary Education and Research in Substance Use and Addiction and receives renumerations from UpToDate. K. A. reports a Maine Department of Health cooperative agreement during the conduct of the study. M. J. M. reports grants from the Delaware Division of Medicaid and Medical Assistance during the conduct of the study and from the University of Delaware, Center for Community Research & Service (funding for 50% of the project). L. A. reports support for attending meetings and/or travel (made to institutions). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Publisher Copyright: © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved.

PY - 2023/5/15

Y1 - 2023/5/15

N2 - Background. Limited information exists about testing for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among Medicaid enrollees after starting medication for opioid use disorder (MOUD), despite guidelines recommending such testing. Our objectives were to estimate testing prevalence and trends for HIV, HBV, and HCV among Medicaid enrollees initiating MOUD and examine enrollee characteristics associated with testing. Methods. We conducted a serial cross-sectional study of 505 440 initiations of MOUD from 2016 to 2019 among 361 537 Medicaid enrollees in 11 states. Measures of MOUD initiation; HIV, HBV, and HCV testing; comorbidities; and demographics were based on enrollment and claims data. Each state used Poisson regression to estimate associations between enrollee characteristics and testing prevalence within 90 days of MOUD initiation. We pooled state-level estimates to generate global estimates using random effects meta-analyses. Results. From 2016 to 2019, testing increased from 20% to 25% for HIV, from 22% to 25% for HBV, from 24% to 27% for HCV, and from 15% to 19% for all 3 conditions. Adjusted rates of testing for all 3 conditions were lower among enrollees who were male (vs nonpregnant females), living in a rural area (vs urban area), and initiating methadone or naltrexone (vs buprenorphine). Associations between enrollee characteristics and testing varied across states. Conclusions. Among Medicaid enrollees in 11 US states who initiated medications for opioid use disorder, testing for human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and all 3 conditions increased between 2016 and 2019 but the majority were not tested.

AB - Background. Limited information exists about testing for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among Medicaid enrollees after starting medication for opioid use disorder (MOUD), despite guidelines recommending such testing. Our objectives were to estimate testing prevalence and trends for HIV, HBV, and HCV among Medicaid enrollees initiating MOUD and examine enrollee characteristics associated with testing. Methods. We conducted a serial cross-sectional study of 505 440 initiations of MOUD from 2016 to 2019 among 361 537 Medicaid enrollees in 11 states. Measures of MOUD initiation; HIV, HBV, and HCV testing; comorbidities; and demographics were based on enrollment and claims data. Each state used Poisson regression to estimate associations between enrollee characteristics and testing prevalence within 90 days of MOUD initiation. We pooled state-level estimates to generate global estimates using random effects meta-analyses. Results. From 2016 to 2019, testing increased from 20% to 25% for HIV, from 22% to 25% for HBV, from 24% to 27% for HCV, and from 15% to 19% for all 3 conditions. Adjusted rates of testing for all 3 conditions were lower among enrollees who were male (vs nonpregnant females), living in a rural area (vs urban area), and initiating methadone or naltrexone (vs buprenorphine). Associations between enrollee characteristics and testing varied across states. Conclusions. Among Medicaid enrollees in 11 US states who initiated medications for opioid use disorder, testing for human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and all 3 conditions increased between 2016 and 2019 but the majority were not tested.

KW - HIV

KW - Medicaid

KW - hepatitis

KW - opioid use disorder

KW - testing

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U2 - 10.1093/cid/ciac981

DO - 10.1093/cid/ciac981

M3 - Article

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SN - 1058-4838

VL - 76

SP - 1793

EP - 1801

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 10

ER -

Prevalence of Testing for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Among Medicaid Enrollees Treated With Medications for Opioid Use Disorder in 11 States, 2016-2019

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

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