The Division of Mental Health and Addiction Services (DMHAS) Rapid HIV Testing Initiative Update 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 HIV/AIDS Update

 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 HIV/AIDS Update (cont’d)

 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 on- site HIV testing 9% provided specialized programs or groups for individuals living with HIV National HIV and Substance Abuse Data for 2009

 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 Benefits of HIV Testing in Substance Abuse Treatment Programs

 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 DMHAS Funding for HIV-Related Services

 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 MOA 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 Substance Abuse Treatment Programs Approved for Rapid HIV Testing

 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 Federal Block Grant Report

JanFebMarAprMayJunJulAugSepOctNovDecTotal Total DMHAS Rapid HIV Testing Annual Totals

Rapid HIV Tests Done in DMHAS Sites January 2013-December 2013 JanFebMarAprMayJunJulAugSepOctNovDecTotal 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

 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 NJ Substance Abuse Treatment Program Survey

 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%) Results for 19 sites that receive tests from DMHAS

 License new DMHAS sites  Launch Statewide mobile HIV testing pilot  Increase training/education for counselors, nurses and other agency staff Motivational Interviewing (MI) Next Steps: Future Planning to Increase HIV Testing