NIDA Stimulus Grant to Assess the Benefits
of Counseling with HIV Screening
Public health experts encourage everyone between the ages of 13
and 64 to be HIV tested. Researchers at the University of Miami
Miller School of Medicine and the San Francisco Department of Public
Health will determine whether receiving a rapid HIV test and counseling
offers healthier outcomes than rapid testing alone, with a $12.3
million grant awarded through the American Recovery and Reinvestment
Act. The grant is being funded by the National Institute on Drug
Abuse (NIDA), part of the National Institutes of Health.
Currently, there is insufficient scientific evidence for comparisons.
This Recovery Act-funded grant will provide the scientific evidence
needed to guide decisions on the benefit of prevention counseling
for those who test negative. This is in keeping with the Institute
of Medicine's recommendation that determining the role of counseling
with HIV testing is a high priority of comparative effectiveness
research.
This year, randomized multi-center controlled trials will enroll
5,000 patients at high risk for HIV infection in nine sexually
transmitted disease clinics in the United States. The sample size
is large enough to allow meaningful subgroup analyses, including
racial/ethnic groups, age groups, sexual orientation, gender, and
substance abusers.
The study will evaluate the effect of routine counseling at screening
on two primary outcomes: the incidence of sexually transmitted
infections and acceptance of HIV testing. Researchers will also
measure reduction of risky sexual behaviors and substance use during
sex after a six month period, and cost-effectiveness of counseling
and testing.
"This is a good example of how Recovery Act funding will not only
advance knowledge in a high priority area of public health, but
also provide jobs to researchers," said NIH Director Dr. Francis
Collins. "We need to know if counseling linked to testing will
have an impact on reduction of risky behaviors and the diseases
linked to those behaviors for persons who test HIV-negative."
"NIH research previously showed the value of routine HIV screening
in patients with or without elevated risk factors," noted NIDA
Director Dr. Nora Volkow. "Now, we will leverage the infrastructure
already in place through our Clinical Trials Network to address
the issue of whether to provide counseling as part of that screening."
"We are pleased to be a part of such an important public health
investigation," said Dr. Lisa Metsch, who will lead the scientific
team at the University of Miami Miller School of Medicine along
with Dr. Grant Colfax at the San Francisco Department of Public
Health. "Our work will help advance the public health debate about
whether to offer counseling for all patients undergoing HIV screening
in health care settings."
Dr. Colfax, who oversees public HIV testing programs for San Francisco,
added, "Historically, counseling has been a major component to
the testing process. The question is, in this day and age, is there
still some benefit to counseling; if so, for whom, and at what
cost? The results of this study will help us to target our public
health resources more efficiently and effectively."
The study meets the goals of the Recovery Act in providing economic
benefits by creating 47 new positions and retaining 52 positions
at public health clinics, universities, and research centers in
multiple states, including many of those hit hardest by the recession.
The nine study sites, affiliated with the NIDA Drug Abuse Treatment
Clinical Trials Network, are located in Columbia, S.C.; Jacksonville,
Fla.; Los Angeles; Miami; San Francisco; Pittsburgh; Portland,
Ore.; Seattle and Washington. The cost effectiveness analysis will
be done by scientists at Weill Cornell Medical College in New York
City. Data management support will be provided by the Duke Clinical
Research Institute, Durham, N.C. Clinical coordination support
will be provided by EMMES Corp., Bethesda, Md.
The National Institute on Drug Abuse is a component of the National
Institutes of Health, U.S. Department of Health and Human Services.
NIDA supports most of the world's research on the health aspects
of drug abuse and addiction. The Institute carries out a large
variety of programs to inform policy and improve practice. Fact
sheets on the health effects of drugs of abuse and information
on NIDA research and other activities can be found on the NIDA
home page at www.drugabuse.gov. To order publications in English
or Spanish, call NIDA's new DrugPubs research dissemination center
at 1-877-NIDA-NIH or 240-645-0228 (TDD) or fax or email requests
to 240-645-0227 or drugpubs@nida.nih.gov.
Online ordering is available at http://drugpubs.drugabuse.gov.
NIDA's new media guide can be found at http://drugabuse.gov/mediaguide.
NIDA's National Drug Abuse Treatment Clinical Trials Network (CTN)
is a multi-site research project of behavioral, pharmacological,
and integrated treatment interventions to determine effectiveness
across a broad range of community-based treatment settings and
diversified patient populations. The CTN provides a foundation
for conducting research with the primary goal of bridging the gap
between the science of drug treatment and its practice through
the study of scientifically based interventions in real world settings.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.
For information on the NIH's American Recovery and Reinvestment
Act funding, visit http://grants.nih.gov/recovery.
To track the progress of HHS activities funded through the recovery
act, visit www.hhs.gov/recovery.
To track all federal funds provided through the recovery act, visit www.recovery.gov. |