HIV, hepatitis B (HBV) and hepatitis C (HCV) testing increased among Medicaid enrollees seeking opioid use disorder treatment; however, nearly 75% of enrollees did not receive such testing, according to a recent study.
“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,” said Katherine Ahrens, PhD, epidemiologist and assistant research professor in the public health program at the University of Southern Maine Muskie School of Public Service, in a Healio article. “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.”
Published in Clinical Infectious Diseases, the study analyzed Medicaid data from 11 states spanning 2016 to 2019. Researchers observed testing within the first 90 days of starting MOUD in 361,537 Medicaid enrollees ages 12 to 64.
They found that between 2016 and 2019, HIV testing increased from 20% to 25%, HBV testing increased from 22% to 25% and HCV testing increased from 24% to 27. Testing for each of the three conditions also increased from 15% to 19%.
Men had lower rates of testing for all three conditions compared with nonpregnant women, those who live in rural areas and those starting methadone or naltrexone, medications used to treat opioid use disorder, compared with those taking buprenorphine, a similar but weaker medication for opioid use disorder.
“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.”