Steven Saunders, MS, Director, HIV Prevention DHSTS, NJDOH

First Place Winner 2013 ASTHO Vision Award

 HIV incidence driven by two distinct PLWH populations: 1. Unaware of their HIV infections 2. Aware, but not in HIV care and on ARVs  Targets specific population of HIV+s not on ARVs, not at-risk, HIV -s or all PLWH, the targets of past HIV prevention efforts.

 HIV+s not on ARVs account for nearly all remaining HIV transmission.  They are a relatively small, finite number.  Nearly all of whom are potentially reachable by a comprehensive prevention with positives strategy such as the HPPNP.

Rutgers NJ Medical School in Newark St. Michael’s Medical Center in Newark Jersey City Medical Center in Jersey City Jersey Shore University Medical Center in Neptune Atlanticare Regional Medical Center in Atlantic City Cooper Health System in Camden St. Joseph’s Hospital and Medical Center in Paterson Trinitas Regional Medical Center in Elizabeth

Provides “concierge service” for initially positive patients identified in other community settings Testing and linkage to care may be incentivized Ensure or facilitate immediate, accompanied patient transportation to HIV clinic where seen by RN/PA/MD Direct cell phone line to Navigator shared among all MOA signatories and NJ AIDS/STD Hotline Works with CBOs to assist in re-engagement

Provide 2nd rapid test for patients testing + on their 1st rapid test at CBOs or other non RTA test sites – same or next business day Immediately enroll confirmed +s into care sees Nurse or Doctor for initial work-up CD4, VL on same day as 2nd rapid test - If p24 Ag+, or symptomatic (AHI or AIDS) MD must see that day too. Partner Services for new and existing clinic patients using Contact Elicitation and Social Networking Re-engagement of HIV practice patients lost to care Treatment adherence and prevention counseling Local Linkage to Care Collaborative Point Person and MOA Manager

Conduct RTA walk-in testing and link positives to care Provide 2nd rapid test to in-patients who test positive on initial screening, and link them to care prior to discharge Conduct 2 nd rapid test for 1 st test positive patients identified by DHSTS PS staff and link positives to care Link HIV positive NJ AIDS/STD Hotline callers to care Link released inmates to care - prison discharge planners Advocate for routine (hospital-wide) HIV screening

 New Jersey AIDS/STD Hotline ◦ HIV+ callers linked to Navigator cell phones via 3-way ◦ 23 out-of-care individuals linked to care Jan-June 2013  RW Part B MAI Pre-release Discharge Planners ◦ Six grantees cover 11 of 13 state prisons ◦ Collectively provide discharge planning services to 206 pre-release HIV+ inmates annually  DOH Partner Services staff ◦ Linked 20 HIV+ to Navigators in 2013

Majority of new patients (1106) seen were African American (61%) and male (64%); 22% were Hispanic; 15% were years old; majority were (49%), largest single age group was (27%) 67 2 nd (R2R) rapid HIV tests conducted; 96% positive (4% discordant) and all +s (100%) enrolled in care 821 other HIV tests (RTA) conducted, 44 positive (5%) and 84% enrolled in care and 245 partners/social contacts tested, 10 (4%) positive 521 re-engaged in care; 639 total linked to care

 1690 Treatment Adherence sessions for HIV patients  1592 prevention with positives counseling sessions for HIV patients  17,725 condoms distributed to HIV patients  482 HIV patients were linked back out to community-based prevention services