Prevalence of Testing for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus Among Medicaid Enrollees Treated With Medications for Opioid Use Disorder in 11 States, 2016–2019

Authors

Katherine A. Aherns MPH, PhD, Muskie School of Public Service, University of Southern Maine
Michael Sharbaugh, Department of Health Policy and Management, University of Pittsburgh, School of Public Health , Pittsburgh
Marian P. Jarlenski, Department of Health Policy and Management, University of Pittsburgh, School of Public Health , Pittsburgh
Lu Tang, Department of Biostatistics, University of Pittsburgh, School of Public Health , Pittsburgh, Pennsylvania
Lindsay Allen, Health Policy, Management, and Leadership Department, School of Public Health, West Virginia University
Anna E. Austin, Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
Andrew J. Barnes, Health Behavior and Policy Department, School of Medicine, Virginia Commonwealth University
Marguerite E. Burns, Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin
Sarah Clark, Department of Pediatrics, School of Medicine, University of Michigan
Kara Zivin, Department of Psychiatry, School of Medicine, University of Michigan
Aimee Mack, Government Resource Center, Ohio Colleges of Medicine, Ohio State University
Gilbert Liu, Government Resource Center, Ohio Colleges of Medicine, Ohio State University
Shamis Mohamoud, Hilltop Institute, University of Maryland Baltimore County
Mary Joan McDuffie, Center for Community Research & Service, Biden School of Public Policy and Administration, University of Delaware , Newark
Lindsey Hammerslag, College of Medicine, Institute for Biomedical Informatics, University of Kentucky , Lexington
Adam J. Gordon, Program for Addiction Research, Clinical Care, Knowledge and Advocacy, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine , Salt Lake City
Julie M. Donohue, Department of Health Policy and Management, University of Pittsburgh, School of Public Health , Pittsburgh

Document Type

Article

Publication Date

1-3-2023

Publication Title

Clinical Infectious Diseases, Volume 76, Issue 10, 15 May 2023, Pages 1793–1801

Keywords

Muskie, Faculty Scholarship, testing, Medicaid, opioid use disorder, HIV, hepatitis

Abstract

Background

Limited information exists about testing for human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among Medicaid enrollees after starting medication for opioid use disorder (MOUD), despite guidelines recommending such testing. Our objectives were to estimate testing prevalence and trends for HIV, HBV, and HCV among Medicaid enrollees initiating MOUD and examine enrollee characteristics associated with testing. Methods

We conducted a serial cross-sectional study of 505 440 initiations of MOUD from 2016 to 2019 among 361 537 Medicaid enrollees in 11 states. Measures of MOUD initiation; HIV, HBV, and HCV testing; comorbidities; and demographics were based on enrollment and claims data. Each state used Poisson regression to estimate associations between enrollee characteristics and testing prevalence within 90 days of MOUD initiation. We pooled state-level estimates to generate global estimates using random effects meta-analyses. Results

From 2016 to 2019, testing increased from 20% to 25% for HIV, from 22% to 25% for HBV, from 24% to 27% for HCV, and from 15% to 19% for all 3 conditions. Adjusted rates of testing for all 3 conditions were lower among enrollees who were male (vs nonpregnant females), living in a rural area (vs urban area), and initiating methadone or naltrexone (vs buprenorphine). Associations between enrollee characteristics and testing varied across states. Conclusions

Among Medicaid enrollees in 11 US states who initiated medications for opioid use disorder, testing for human immunodeficiency virus, hepatitis B virus, hepatitis C virus, and all 3 conditions increased between 2016 and 2019 but the majority were not tested.

Recommended Citation

Ahrens, K., Sharbaugh, M., Jarlenski, M. P., Tang, L., Allen, L., Austin, A. E., Barnes, A. J., Burns, M. E., Clark, S., Zivin, K., Mack, A., Liu, G., Mohamoud, S., McDuffie, M. J., Hammerslag, L., Gordon, A. J., Donohue, J. M., & Writing Committee for Medicaid Outcomes Distributed Research Network. (2023). Prevalence of Testing for Human Immunodeficiency Virus, Hepatitis B Virus, and Hepatitis C Virus among Medicaid Enrollees Treated with Medications for Opioid Use Disorder in 11 States, 2016–2019. Clinical Infectious Diseases. https://doi.org/10.1093/cid/ciac981