Date of Award
2026
Document Type
Doctor of Nursing Practice (DNP)
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
Committee Chair
Yeow Chye Ng
Committee Member
Warren Tyon
Subject(s)
HIV infections--Diagnosis, Sexually transmitted diseases--Diagnosis, Substance abuse treatment facilities, Medical screening
Abstract
People who use drugs are at increased risk of contracting human immunodeficiency virus (HIV) infection, hepatitis B infection, hepatitis C, and sexually transmitted infections (STIs) due to high-risk behaviors, including needle sharing, incarceration, multiple sex partners, and unprotected sex. Individuals with substance use disorders are also at increased risk for liver dysfunction, renal impairment, and other medical comorbidities associated with chronic substance use. Although many organizations, including the Centers for Disease Control and Prevention (CDC), recommend routine screening and laboratory monitoring in high-risk populations, many addiction treatment facilities in the United States lack standardized protocols for bloodborne infection, STI screening, and routine laboratory monitoring. Early identification of infectious diseases and medical complications through comprehensive screening including HIV, hepatitis B, hepatitis C, and bacterial STIs, as well as complete blood count (CBC), comprehensive metabolic panel (CMP), TSH, and HgbA1c, improves patient outcomes, facilitates early linkage to care, and reduces transmission within the community. This Doctor of Nursing Practice (DNP) project incorporated opt-out HIV screening into an existing STI screening bundle and bloodwork called the Protect+ Panel. The Protect+ Panel was offered to all new patients seeking medication-assisted treatment (MAT) at an opioid addiction treatment facility, while also expanding the same panel to all existing patients for annual lab work. The protocol included the Protect+ Panel, providing opt-out HIV, hepatitis, and bacterial STI screening, as well as routine laboratory evaluation. Every provider at the facility participated in the implementation and integrated the Protect+ Panel into their routine practice workflow (100% participation and adoption), confirming strong intervention fidelity. Following implementation, 78.4% of eligible patients (652/832) accepted HIV screening, representing a dramatic increase from the pre-implementation baseline of 0%. Hepatitis C virus was the most prevalent finding, identified in 30.1% of those screened, underscoring the significant burden of bloodborne infection in this population. Patients with positive HIV or hepatitis results were referred for early linkage to care at an infectious disease or specialty care clinic. Patients with a positive HIV result were also referred to the clinic psychotherapist for psychosocial support.
Recommended Citation
Bass, Stephanie, "Integrating routine HIV screening into a sexually transmitted infection panel at an opioid addiction treatment facility: a DNP clinical practice change" (2026). Doctor of Nursing Practice (DNP). 165.
https://louis.uah.edu/uah-dnp/165