Research Meets Practice and Beyond: Clinical Implementation of HIV Rapid Testing CTN Anniversary Celebration April 21, 2010 Louise Haynes, MSW Beverly Holmes, MSW LRADAC, Columbia, SC

“The Bridge” NIDA Clinical Trials Network

Building the Bridge Maturing in the CTN   In the beginning….Learning how to conduct the research successfully   Then…Increasing the acceptance of research in participating community programs   After that….Disseminating findings to a welcoming audience of providers   Finally…….Implementing research-based interventions

CTN trial for HIV testing and counseling (CTN0032)   Eligible sites not offering testing   Inpatient and outpatient sites   Methadone and psychosocial rehab   Used rapid test – 20 minutes for results   3 arms: counseling and offer of testing, information and offer of testing, off-site referral   Which approach was more effective for getting tested and receiving results?   N = 1200   Ended 12-09

Rapid On-site HIV Testing and Counseling   Could we conduct the protocol successfully?   Rapid recruitment   Would clients agree to participate, particular concerns about men

Implementation: Getting Past the Discussion Phase   Following each research project there was an initial interest in implementing the intervention: TELE, Adol ADHD, HIV risk reduction for men and women (group)   A first: HIV Testing and Counseling in Substance Abuse Treatment

What made 0032 different from previous protocols?   Research fully integrated into treatment program   Immediate implementation   External funding and support for programmatic implementation (cost neutral to agency)   Champion

Implementation CDC Guidelines Research Single State Authority State Health Dept CTP Administration Clients

What did the CTN offer?   Experience – conducting the research offered the opportunity for the agency to try out the intervention which turned out to be very popular with clients   Training: both research staff and later for program staff   Continued supervision and support

Nuts and Bolts of Implementation   Planning Program, Clients, Procedures, State Requirements   Phase 1- Detox   Staffing/training   Testing/counseling   From research based to clinic based   Phase 2: Outpatient Program Outpatient Groups Outpatient Intake Orientations

Implementation   Since September 8, Rapid Tests Offered 194 Accepted 61% Acceptance Rate   Reasons offer not accepted 69% Recently tested 10% HIV positive Other reasons such as: perceived no risk, undecided about being tested, not interested

Client Demographics   Clients Tested (detox) 32% Female 49% African American   Research protocol at LRADAC (outpatient) 45% Female 56% AA   Average 7 per week

Opportunities   South Carolina School of Alcohol and Drug Studies   Collaboration with SSA (DAODAS) and SC state health department (DHEC)   Team teaching: CTN, ATTC, DHEC   Certification upon course completion

Conclusions   Research Experience in CTN can lead to improvement in agency’s treatment program   Potential to reach beyond agency – state wide implementation   Importance of RRTC support

For more information contact:   Beverly Holmes:   Louise Haynes:

Thanks   LRADAC   Lisa Metsch, Lauren Gooden, lead team of CTN0032   Kathleen Brady, PI, Southern Consortium

LRADAC & Morris Village Research Staff