Research Meets Practice and Research Meets Practice and Beyond:Beyond:

Clinical Implementation of HIV Clinical Implementation of HIV Rapid TestingRapid Testing

CTN Anniversary CelebrationApril 21, 2010

Louise Haynes, MSWBeverly Holmes, MSW

LRADAC, Columbia, SC

““The Bridge”The Bridge”NIDA Clinical Trials NetworkNIDA Clinical Trials Network

2000-20102000-2010

Building the BridgeMaturing 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 CTN trial for HIV testing and counseling (CTN0032)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 Rapid On-site HIV Testing and Counseling 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

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, 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

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: holmesbe@musc.edu Louise Haynes: hayneslf@musc.edu

Thanks

LRADAC Lisa Metsch, Lauren Gooden, lead team of

CTN0032 Kathleen Brady, PI, Southern Consortium

LRADAC & Morris Village Research Staff