Human Immunodeficiency Virus Testing Practices Among Buprenorphine-Prescribing Physicians

Opioid dependence traditionally has been treated with methadone. Buprenorphine also is effective in treating drug addiction to heroin and prescription opioids and can be prescribed by physicians—generalists, psychiatrists and addiction specialists—registered with the Drug Enforcement Administration.

The Centers for Disease Control and Prevention (CDC) advocates annual HIV testing for high-risk individuals, which include opioid-dependent patients (due to their needle sharing and sexual risk behaviors). Buprenorphine-prescribing physicians, therefore, are well-positioned to conduct HIV testing on this population.

Researchers conducted a web-based survey of physicians involved in the Substance Abuse and Mental Health Services Administration (SAMHSA)-funded Physician Clinical Support System for buprenorphine. They collected demographic data about physicians, their clinical training and experience with prescribing buprenorphine, as well as information about their patients. Most of the survey participant physicians were White (76%) and male (74%) as were their patients receiving buprenorphine (79% White; 61% male).

Physicians screen at every visit for alcohol use (65%), substance use (84%) and cigarette smoking (40%). Yet 46 percent of physicians reported ever conducting HIV testing. Those who do test for HIV are more likely to practice in an addiction setting and have more than three years of experience prescribing buprenorphine to at least 50 patients.