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

Clinical Implementation of HIV Clinical Implementation of HIV Rapid TestingRapid Testing

Dissemination WorkshopOctober, 2009

Louise Haynes, MSWBeverly Holmes, MSWLRADAC, Columbia, SC

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

2000-20102000-2010

LRADAC participated in CTN0018 and 19 LRADAC participated in CTN0018 and 19 (Safer Sex Protocols) and CTN0032 (HIV (Safer Sex Protocols) and CTN0032 (HIV Rapid Testing)Rapid Testing)

In process of piloting implementation of In process of piloting implementation of HIV risk reduction counseling and on site HIV risk reduction counseling and on site rapid testingrapid testing

Site PI and RA/Study CoordinatorSite PI and RA/Study Coordinator Describe process of transitioning from Describe process of transitioning from

research to clinical practiceresearch to clinical practice

Case StudyCase StudySuccessful Successful CLINICAL CLINICAL Implementation of Implementation of

HIV Risk Reduction InterventionHIV Risk Reduction Intervention

Integrated into routine clinic practicesIntegrated into routine clinic practices Acceptability to clientsAcceptability to clients Leadership supportLeadership support Champion (Beverly Holmes)Champion (Beverly Holmes)

OpportunitiesOpportunities

Initiative to implement HIV testing in public CTPsInitiative to implement HIV testing in public CTPs Joint project between SSA and State Health DeptJoint project between SSA and State Health Dept Funding available but little implementationFunding available but little implementation LRADAC recognized for having experience and LRADAC recognized for having experience and

knowledge to promote implementationknowledge to promote implementation Approval from the State Health DeptApproval from the State Health Dept

CLIA WaiverCLIA Waiver TrainingTraining Testing KitsTesting Kits Set up procedures for confirmatory testing and linkage to careSet up procedures for confirmatory testing and linkage to care SOPsSOPs

Organizational ChangeOrganizational Change

Detox as pilot (not eligible for participation Detox as pilot (not eligible for participation in CTN0032)in CTN0032)

CTN032 staffCTN032 staff Buy in from detox staffBuy in from detox staff Full agency implementation in January Full agency implementation in January

20102010

IMPLEMENTATIONIMPLEMENTATION

Nuts and BoltsNuts and Bolts

Screening on detox unitScreening on detox unit AppointmentsAppointments Counseling and testing in officesCounseling and testing in offices

FingerstickFingerstick Respect 2 CounselingRespect 2 Counseling

Testing approximately 7 clients per weekTesting approximately 7 clients per week

Client Demographics Client Demographics

Detox: Detox: 20 to 25% Female 20 to 25% Female 40 to 50% African American40 to 50% African American

Clients tested consistent with detox population Clients tested consistent with detox population CTN 0032 at LRADAC (adult outpatient) CTN 0032 at LRADAC (adult outpatient)

45% Female 45% Female 56% AA56% AA

LRADAC Adult Outpatient: LRADAC Adult Outpatient: 39% Female 39% Female 56% AA 56% AA

ConclusionsConclusions

Research Experience in CTN can lead to Research Experience in CTN can lead to improvement in agency’s treatment improvement in agency’s treatment programprogram

Potential to reach beyond agency – state Potential to reach beyond agency – state wide implementationwide implementation

Importance of RRTC and agency supportImportance of RRTC and agency support

For more information contact:For more information contact:

Beverly Holmes: Beverly Holmes: holmesbe@musc.eduholmesbe@musc.edu Louise Haynes: Louise Haynes: hayneslf@musc.edu hayneslf@musc.edu

ThanksThanks

LRADACLRADAC Lisa Metsch, Lauren Gooden, lead team of Lisa Metsch, Lauren Gooden, lead team of

CTN0032CTN0032 Kathleen Brady, PI, Southern ConsortiumKathleen Brady, PI, Southern Consortium