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 |
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Pages (from-to) | 1793-1801 |
Number of pages | 9 |
Journal | Clinical Infectious Diseases |
Volume | 76 |
Issue number | 10 |
DOIs | |
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