Download DAS - njhiv1.org

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 riskreduction.
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
MSM
IVDU
MSM/
IVDU
Contact
at risk
Other
New Jersey
Rapid HIV Testing




Counseling sites started in mid1980s
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




Regular monitoring




Temperature monitoring
QC quality control
Proficiency Testing
Review of logs
Site visits
“Report card”
2 MD, 1 PhD, 1 manager, 6 techs
HIV detection
Group N
?
Group M
Group O
HIV-1
?
HIV-2
HIV Serotypes
HIV Infection
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 “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
September 10: not tested
B
C
D
September 30: not tested
October 31:
HIV EIA Positive;
Western Blot indeterminate
HIV Infection
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 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
40
35
30
25
Historic
Recent
20
15
10
5
0
Male
Total

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