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NJHIV. Capacity Building Workshop for Division of Addiction Services Treatment Centers December 8, 2009. New Jersey and AIDS. New Jersey is a high prevalence state 5 th in the US in cumulative reported AIDS cases 3 in cumulative reported pediatric AIDS cases
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NJHIV Capacity Building Workshop for Division of Addiction Services Treatment Centers December 8, 2009
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
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.
HIV cases among IVDU • Historically, 41% of HIV cases in New Jersey are among IVDU
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
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
HIV Serotypes HIV detection
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
HIV “Window” • Early in infection, antibody test will be negative. • Repeat testing is necessary • RNA testing may shorten this window period
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
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
HIV Detection • Currently test for antibody production • Confirmatory test in state laboratory • RNA testing in pilot programs
NJ HIV testing • 68,000 tests 3 years ago • Over 90,000 tests this year
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
New York City IVDU: • 1990s >30% seropositivity • 2000s 5-6% seropositivity • Most cases are old • New cases < 1% per year
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
Goal is for twice a year HIV testing in drug abuse population
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
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