Program characteristics associated with testing for HIV and hepatitis C in veterans substance use disorder clinics.

Objective: This study examined whether organizational characteristics and quality improvement initiatives were related to HIV and hepatitis C (HCV) testing rates in veterans’ substance use disorders programs. Methods: Data were collected by surveying 232 program directors at all U.S. Department of Veterans Affairs (VA) substance use disorder programs. Results: Program directors (N=223) reported that, on average, 35% of their patients were tested for HIV (median=10%) and 57% were tested for HCV (median=80%). Of the quality improvement initiatives examined, computerized reminders to clinicians (p=.02) and a designated clinician for screening (p=.01) were positively associated with HCV testing, and computerized templates that guide clinicians through ordering of testing were positively associated with HIV testing (p=.06). Conclusions: Despite national emphasis on HIV testing, rates of testing were lower for HIV than for HCV in programs serving veterans with substance use disorders and at risk of both illnesses. System-level quality improvement initiatives may be effective at increasing rates of infectious disease screening. (Psychiatric Services 61:90–94, 2010)