July 25, 2013

 36,648 people were reported to be living with HIV or
AIDS in New Jersey as of December 31, 2012
 Injection Drug Use (IDU) and sexual contact remain the major modes of exposure to HIV infection
 The proportion of reported cases with HIV/AIDS who were exposed through IDU is lower than in the past, while the proportion of cases that were exposed through sexual contact is increasing

 Seventy-nine percent of persons living with HIV/AIDS are 40 years of age or older
 Thirty-four percent of those living with HIV/AIDS are females
 Fifty-three percent of females living with HIV are currently between the ages of 20-49

 According to the National Survey of Substance
Abuse Treatment Services (N-SSATS)
• Slightly more than half (55%) of all substance abuse treatment facilities reported providing HIV/AIDS education and counseling to their clients
• 28% of substance abuse treatment facilities provided onsite HIV testing
• 9% provided specialized programs or groups for individuals living with HIV

Benefits of HIV Testing in Substance
Abuse Treatment Programs
 Counseling and testing strategies reduce high-risk behavior
 Reduces transmission of HIV to others, including perinatal transmission
 Improves client survival and life expectancy:
Linkage to care and treatment
 Disease progression is slowed with early intervention

 DMHAS spends 5% of its State Set-Aside Block Grant
(Federal funding) on HIV-Related Services
• DMHAS contracts for Early Intervention Services (EIS) at five (5) substance abuse treatment agencies and funds HIV Case
Management positions at fourteen (14) agencies
• Obligates funds through a Memorandum of Agreement (MOA) with RWJ Medical School to implement rapid HIV testing technology at licensed substance abuse treatment agencies
• Obligates a small portion of funds through a MOA with the Public
Health and Information Environmental Laboratory (PHILEP) ensuring a provision of testing and diagnostic support services for DAS licensed treatment agencies

 Robert Wood Johnson Key Responsibilities
• Provides administrative services to include consultation and lab oversight to ensure rapid HIV testing for clients in State licensed substance use disorder treatment programs
• Ensures personnel training programs are in place so that personnel conducting rapid HIV tests are trained in appropriate testing procedures
• Provides technical assistance to DMHAS agencies to ensure clients are offered testing at admission and again thereafter every six months (for those individuals who test negative)
• Assumes role of inventory manager purchasing all test kits, controls and other bulk laboratory supplies
• Collects data and maintains reporting systems for all sites for the purpose of facilitating monthly reporting to DMHAS

Substance Abuse Treatment Programs
Approved for Rapid HIV Testing
 Any NJ State licensed Opioid Treatment Program (OTP)
 HIV-funded Substance Abuse and Mental Health Services Administration
(SAMHSA) grantees
 Programs in cities where a current Syringe Access Program (SAP) is located
• Atlantic City
• Camden
• Jersey City
• Newark
• Paterson
 Any licensed substance abuse treatment program that is within one of the four top “Impact Counties” for People Living with HIV/AIDS (PLWHA)
• Essex
• Hudson
• Union
• Passaic

 Number of individuals tested for HIV
 Number of HIV tests conducted
 Number of tests that were positive for HIV
 Number of individuals who prior to the 12-month reporting data were unaware of their HIV infection
 Number of HIV-infected individuals who were diagnosed and referred into treatment and care during the 12-month period

DMHAS Rapid HIV Testing Annual Totals
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total
2008 0 0 0 0 24 21 21 23 30 30 26 32 207
2009 35 35 44 47 90 57 53 48 66 73 67 83 698
2010 153 96 113 144 122 129 165 188 176 214 236 167 1903
2011 193 246 294 259 274 264 303 264 221 227 190 180 2915
2012 266 207 275 247 270 311 314 246 195 228 147 232 2938
2013 296 223 228 248 229 245 0 0 0 0 0 0 1469
Total 10130

Rapid HIV Tests Done in DMHAS Sites
January 2013-December 2013
Bethel Counseling
Burlington Comprhensive
Center For Great Expectations
CURA
Delaware Valley Medical
Hope House
Inter County Council
John Brooks Recovery Center
John Brooks Recovery ROW
Khaleidoscope
JSAS
North East Life Skills
New Horizon Treatment Services
Ocean Medical
Organization for Recovery
Paterson Counseling Center
Somerset Treatment Services
Spectrum Health Care
Stateline Medical
Team Management 2000 Hackensack
Team Management 2000 West Orange
The Lennard Clinic Newark
The Lennard Clinic Elizabeth
Turning Point
Urban Renewal
Women Of Hope Resource Center
Total
15
7
0
24
79
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
19 18 0 0 0 0 0 0 0 0 0 0
17
0
12
2
14
1
18
1
24
4
9
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
30
11
1
3
3
22
0
46
0
0
0
0
4
0
15
0
3
9
1
67
0
0
0
27
5
0
0
0
15
0
32
4
11
0
0
7
0
10
0
15
9
0
4
3
0
3
0
2
0
20
1
5
5
0
5
4
0
0
0
0
0
8
0
5
0
0
3
16
0
0
1
0
0
5
7
7
8
0
4
59 86 78 49
7
0
25 26 25 19
3 4 1 7
15
1
15
20 15 21 27
12
4
3
29 43 19 38
0 1 4 4
5
4
0
5
8
0
11 14
0 0
2
8
0
6
0
2
0
4
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
296 223 228 248 229 245 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Total
37
94
13
50
38
1
107
351
30
0
152
31
19
5
20
140
9
16
36
0
58
0
120
12
115
15
1469

 Objective
• To examine current HIV testing practices
• Identify barriers to implementing rapid
HIV testing
 Methods
• Survey Monkey link sent to 205 licensed substance abuse treatment agencies in
December 2011

 Report 50% or more of their current clients have been
HIV-tested
• 52.6% of programs
 44% of programs take “opt-out” approach for testing clients
 Most common barriers to HIV testing:
• Client disinterest (32%)
• HIV related stigma (26%)
• Inadequate staffing (21%)
• Staff or employee work load (16%)
• Phlebotomy not available (16%)

 Reasons clients refuse testing
• Percent of licensed sites that report clients frequently or always refuse for the following reason: o Client already knows status (47%) o Client doesn’t believe he/she is at risk (32%) o Not a priority to client (16%) o Client doesn’t want to know his/her HIV status (16%) o Fear (37%) o Client wants to get tested elsewhere (5%)

 License new DMHAS sites
 Launch Statewide mobile HIV testing pilot
 Increase training/education for counselors, nurses and other agency staff
• Motivational Interviewing (MI)