HIV and Hepatitis C Virus Infection Testing Among Commercially Insured Persons Who Inject Drugs, United States, 2010-2017.

BACKGROUND: We assessed prevalence of testing for HIV and hepatitis C virus (HCV) infection among persons who inject drugs (PWID).

METHODS: Using a nationwide health insurance database for claims paid during 2010-2017, we identified PWID by using codes from the International Classification of Diseases, Current Procedural Terminology, and National Drug Codes directory. We then estimated the percentage of PWIDs tested for HIV or HCV within 1 year of an index encounter, and used multivariate logistic regression models to assess demographic and clinical factors associated with testing.

RESULTS: Of 844 242 PWIDs, 71 938 (8.5%) were tested for HIV and 65 188 (7.7%) for HCV infections. Missed opportunities were independently associated with being male (ORs: HIV, 0.50 [95% CI, 0.49-0.50]; P < .001; HCV, 0.66 [95% CI, 0.65-0.72]; P < .001), rural residence (ORs: HIV, 0.67 [95% CI, 0.65-0.69]; P < .001; HCV, 0.75 [95% CI, 0.73-0.77]), and receiving services for skin infections or endocarditis (aORs: HIV, 0.91 [95% CI, 0.87-0.95]; P <.001; HCV, 0.90 [95% CI, 0.86-0.95]; P <.001).

CONCLUSION: Approximately 90% of presumed PWIDs missed opportunities for HIV or HCV testing, especially male rural residents with claims for skin infections or endocarditis, commonly associated with injection drug use.