HIV, HBV, HCV testing up among Medicaid enrollees, although missed opportunities remain
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Testing for HIV, hepatitis B, and hepatitis C increased among U.S. Medicaid enrollees initiating treatment for opioid use disorder. However, a recent study showed approximately three-quarters of enrollees were not tested for each condition.
“Limited information exists about testing for HIV, hepatitis B virus, and hepatitis C virus among persons enrolled in Medicaid who are starting medication treatment for their opioid use disorder, despite guidelines recommending such testing,” Katherine Ahrens, PhD, epidemiologist and assistant research professor in the Public Health Program at the University of Southern Maine Muskie School of Public Service, told Healio. “Testing for these conditions is recommended because past or current injection drug use is common among persons starting medication treatment for opioid use disorder (MOUD), and highly effective treatments exist for all three diseases that lower the risk of subsequent morbidity, prevent disease transmission, and are cost-saving.”
Because of this, Ahrens and colleagues assessed 2016-2019 Medicaid data from 11 states using a distributed research network called MODRN.
According to the study, the researchers looked at testing within 90 days of starting MOUD among 361,537 Medicaid enrollees aged 12 to 64 years. Measures of MOUD initiation, as well as HIV, HBV, and HCV testing, comorbidities and demographics were based on enrollment and claims data.
Between 2016 and 2019, testing for HIV increased from 20% to 25%, whereas testing for HBV and HCV increased from 22% to 25% and 24% to 27%, respectively. Additionally, testing for all three conditions increased from 15% to 19%.
The researchers determined that rates of testing for all three conditions were lower among enrollees who were male compared with nonpregnant females, those living in a rural area compared with an urban area, and those initiating methadone or naltrexone compared with those initiating treatment with buprenorphine.
“Using a distributed research network in 11 states, we found 90-day testing for HIV, HBV, HCV, and all three conditions increased from 2016 to 2019 among enrollees initiating medication treatment for their opioid use disorder,” Ahrens said. “However, approximately three-quarters of enrollees were not tested within 90 days, highlighting room for improvement in meeting testing recommendations and missed opportunities for curing HCV, managing HBV and HIV, and reducing transmission of these viruses.”
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Ahrens K, et al. Clin Infect Dis. 2022;doi:10.1093/cid/ciac981.
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