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HIV Capacity Building Workshop for Division of Addiction Services Treatment Centers

This workshop aims to enhance HIV testing and prevention efforts in Division of Addiction Services treatment centers. The focus is to catch up with DHAS programs and increase the capacity to apply for supplemental SAMHSA funding.

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HIV Capacity Building Workshop for Division of Addiction Services Treatment Centers

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  1. NJHIV Capacity Building Workshop for Division of Addiction Services Treatment Centers December 8, 2009

  2. New Jersey and AIDS • New Jersey is a high prevalence state • 5th in the US in cumulative reported AIDS cases • 3 in cumulative reported pediatric AIDS cases • 1st in proportion of women with AIDS among cumulative reported AIDS cases

  3. Why test? • People who know they are infected with HIV are more likely to practice risk-reduction. • More people learn their HIV status, and can be referred for treatment, prevention programs, and social services.

  4. HIV cases among IVDU • Historically, 41% of HIV cases in New Jersey are among IVDU

  5. Counseling sites started in mid-1980s Testing added in late 1980s Rapid testing added in 2003 70 laboratory licenses Health Departments, STD clinics, CBOs, Faith-based initiatives, Hospitals, Mobile vans, Field counselors 23 Emergency Departments 2006 ASTHO Vision Award New Jersey Rapid HIV Testing

  6. Inventory control & /validation Training Ongoing QA Temperature monitoring QC quality control Proficiency Testing Regular monitoring Review of logs Site visits “Report card” 2 MD, 1 PhD, 1 manager, 6 techs New Jersey Rapid HIV Testing

  7. HIV Serotypes HIV detection

  8. Symptoms Antibody by 1st gen EIA Antibody by Western Blot Antibody by 3rd gen EIA Antigen RNA / NAAT Acute Infection Silent Infection AIDS Weeks after infection 5-10 years 1-3 years HIV Infection

  9. HIV “Window” • Early in infection, antibody test will be negative. • Repeat testing is necessary • RNA testing may shorten this window period

  10. A August 4: HIV Ab Negative B September 10: not tested C September 30: not tested D October 31: HIV EIA Positive; Western Blot indeterminate

  11. Symptoms Antibody by 1st gen EIA Antibody by Western Blot Antibody by 3rd gen EIA Antigen RNA / NAAT Acute Infection Silent Infection AIDS Weeks after infection 5-10 years 1-3 years HIV Infection

  12. HIV Detection • Currently test for antibody production • Confirmatory test in state laboratory • RNA testing in pilot programs

  13. NJ HIV testing • 68,000 tests 3 years ago • Over 90,000 tests this year

  14. HIV cases among IVDU • Historically, 38% of new HIV cases were among IVDU • In the last year, only 8% of reported HIV cases were from IVDU

  15. New York City IVDU: • 1990s >30% seropositivity • 2000s 5-6% seropositivity • Most cases are old • New cases < 1% per year

  16. New York City IVDU: • HIV incidence parallels Herpes Simplex Virus infection • HIV incidence does NOT parallel Hepatiti C Virus infection • IVDU population engages in high-risk sexual activity

  17. Goal is for twice a year HIV testing in drug abuse population

  18. Goal is for twice a year HIV testing in drug abuse population • SAMHSA initiatives in place to promote HIV prevention activities • Award of ~$250,000 in New Jersey from SAMHSA

  19. Today’s Focus • Help DAS programs catch up to DHAS programs in HIV testing and prevention efforts • Help DAS programs to be in a position to apply for supplemental SAMHSA funding • Work together to increase HIV testing

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