ABucon Rapid HIV Testing Initiative 7.25.13

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The Division of Mental Health and
Addiction Services (DMHAS)
Rapid HIV Testing
Initiative Update
July 25, 2013
HIV/AIDS Update
 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
HIV/AIDS Update (cont’d)
 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
National HIV and Substance
Abuse Data for 2009
 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 Funding for
HIV-Related Services
 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
MOA for Rapid HIV Testing
 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
DMHAS Federal Block Grant Report




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
193 246 294 259 274 264 303 264
221 227 190 180
2915
2011
2012 266 207 275 247 270
311 314 246 195 228 147
2013 296 223 228 248 229 245
Total
0
0
0
0
0
232
2938
0
1469
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
Jan
19
17
0
15
7
0
24
79
0
0
30
11
1
3
3
22
0
46
0
0
0
0
4
0
15
0
Feb
18
12
2
3
9
1
67
0
0
0
27
5
0
0
0
15
0
32
4
11
0
0
7
0
10
0
Mar
0
14
1
15
9
0
4
59
3
0
25
3
3
0
2
20
0
20
1
29
0
5
4
0
11
0
Apr
0
18
1
5
5
0
5
86
4
0
26
4
0
0
0
15
0
8
0
43
1
5
8
0
14
0
May
0
24
4
5
0
0
3
78
16
0
25
1
0
1
0
21
0
5
7
19
4
2
8
0
6
0
Jun
0
9
5
7
8
0
4
49
7
0
19
7
15
1
15
27
12
4
3
38
4
4
5
0
2
0
Jul
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
Aug
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
Sep
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
Oct
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
Nov
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
Dec
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
120
12
115
15
140
9
16
36
0
58
0
Total
296
223
228
248
229
245
0
0
0
0
0
0
1469
NJ Substance Abuse Treatment
Program Survey
 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
Results for 19 sites that receive tests
from DMHAS
 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%)
Results for 19 sites that receive tests
from DMHAS
 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%)
Next Steps: Future Planning to
Increase HIV Testing
 License new DMHAS sites
 Launch Statewide mobile HIV
testing pilot
 Increase training/education for
counselors, nurses and other
agency staff
• Motivational Interviewing (MI)
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