The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT) has authorized its Minority AIDS Initiative (MAI) grantees to temporarily use grant funds to purchase HIV and hepatitis C self-test kits* that can be mailed to clients receiving substance use disorder treatment. In a May 13 message to the 126 grantees, CSAT’s Kirk James, MD, explained that the temporary approval has been made in recognition of reduced availability of HIV and hepatitis C testing in traditional in-person settings due to widespread stay-at-home orders and social distancing measures in effect because of the COVID-19 pandemic.

“Given the challenges surrounding traditional testing during the current COVID-19 pandemic, SAMHSA has made the decision to temporarily approve your ability to use some of your grant funding to purchase HIV and Hepatitis self test kits,” Dr. James, Acting Targeted Capacity Expansion-HIV Team Lead, informed grantees.

SAMHSA’s notification follows a recent “Dear Colleague” message from CDC that encouraged providers of clinical HIV testing services to “expand their support for HIV self-testing services especially where face-to-face testing services have been disrupted.”

The SAMHSA/CSAT grantees that received this temporary authorization have awards under these programs:

• Targeted Capacity Expansion-HIV: Substance Use Disorder Treatment for Racial/Ethnic Minority Populations at High-Risk for HIV/AIDS and Hepatitis Infection program (TI-17-011; TCE-HIV: High Risk Populations);
• Minority AIDS Initiative: Substance Use Disorder Treatment for Racial/Ethnic Minority Populations at High Risk for HIV/AIDS (TI-19-008; MAI – High Risk Populations); and
• A few grantees on no-cost extensions from the Targeted Capacity Expansion HIV: Substance Use Disorder Treatment for Racial/Ethnic Minority Women at High Risk for HIV/AIDS (TI-16-011, TCE-HIV: Minority Women).

The temporary authorization may also be applicable to other SAMHSA grantees, including some from the Center for Substance Abuse Prevention and the Center for Mental Health Services.

The SAMHSA notice to CSAT grantees reminded them that providing treatment to clients with a substance use disorder remains the first priority and that all purchases of self-test kits are subject to audit. It also stressed the critical importance of having protocols in place for obtaining test results from clients, providing guidance to clients who may receive a preliminary positive test on how to obtain a confirmatory test, and facilitating linkage to appropriate HIV or hepatitis prevention or treatment based on the results.

* Current FDA approved self-administered tests that healthcare providers, substance use disorder treatment providers, and health departments can make available to patients include:

• HIV
  • Rapid over-the-counter HIV test using oral fluid to detect HIV antibodies [read FDA fact sheet] (PDF
  • Mail-in (not rapid) self-specimen collection kits containing supplies to collect a small blood sample from a fingerstick to detect HIV antibodies. Results are usually available (by phone, online, or by return mail) within several days of sending the sample for lab analysis. [read FDA information]
• Hepatitis C
  • Mail-in (not rapid) self-specimen collection kits containing supplies to collect a small blood sample from a fingerstick to detect HCV antibodies. Results are available as described above. [read FDA information]

Note: this post was updated on 6/15/20 to add information about the different self-administered tests that are available.