1. 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

2. “The Bridge” NIDA Clinical Trials Network 2000-2010

3. 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

4. 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

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

6. 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

7. 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

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

9. 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

10. 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

11. Implementation   Since September 8, 2009 319 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

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

13. 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

14. 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

15. For more information contact:   Beverly Holmes: holmesbe@musc.eduholmesbe@musc.edu   Louise Haynes: hayneslf@musc.edu

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

17. LRADAC & Morris Village Research Staff