1. The Division of Mental Health and Addiction Services (DMHAS) Rapid HIV Testing Initiative Update July 25, 2013

2.  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

3.  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 HIV/AIDS Update (cont’d)

4.  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

5.  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

6.  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

7.  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

8.  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

9.  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

10. JanFebMarAprMayJunJulAugSepOctNovDecTotal 200800002421 2330 2632207 200935 44479057534866736783698 2010153961131441221291651881762142361671903 20111932462942592742643032642212271901802915 20122662072752472703113142461952281472322938 20132962232282482292450000001469 Total 10130 DMHAS Rapid HIV Testing Annual Totals

11. Rapid HIV Tests Done in DMHAS Sites January 2013-December 2013 JanFebMarAprMayJunJulAugSepOctNovDecTotal Bethel Counseling1918000000000037 Burlington Comprhensive1712141824900000094 Center For Great Expectations02114500000013 CURA153 55700000050 Delaware Valley Medical79950800000038 Hope House0100000000001 Inter County Council24674534000000107 John Brooks Recovery Center79059867849000000351 John Brooks Recovery ROW003416700000030 Khaleidoscope0000000000000 JSAS302725262519000000152 North East Life Skills115341700000031 New Horizon Treatment Services103001500000019 Ocean Medical3000110000005 Organization for Recovery302001500000020 Paterson Counseling Center221520152127000000120 Somerset Treatment Services0000012000000 Spectrum Health Care463220854000000115 Stateline Medical04107300000015 Team Management 2000 Hackensack01129431938000000140 Team Management 2000 West Orange0001440000009 The Lennard Clinic Newark00552400000016 The Lennard Clinic Elizabeth47488500000036 Turning Point0000000000000 Urban Renewal151011146200000058 Women Of Hope Resource Center0000000000000 Total2962232282482292450000001469

12.  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

13.  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

14.  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

15.  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