NEW JERSEY HIV/AIDS REPORT

Transcription

1 NEW JERSEY HIV/AIDS REPORT June 30, 2011 Chris Christie Governor Kim Guadagno Lt. Governor Public Health Services Branch Division of HIV, STD and TB Services preventing disease with care Mary E. O Dowd, M.P.H. Commissioner

2 2 Division of HIV, STD and TB Services preventing disease with care Office of the Assistant Commissioner (609) Program Management - Evaluation and Monitoring Services Administrative Support Services (609) Medical Director (609) HIV Services Care and Treatment Services (609) AIDS Drug Distribution Program Corrections Initiative Health Insurance Continuation Program HIV Care Consortia HIV Early Intervention Program HIV Home Health Care Program Housing Opportunities for Persons with AIDS Epidemiologic Services (609) Case Reporting Forms Epidemiologic Studies HIV/AIDS Statistics Notification Assistance Program-Newark (973) Prevention and Education Services (609) Community-based HIV Prevention Projects HIV Counseling and Testing Program HIV Prevention Community Planning Group HIV-related Training Printed Material Distribution Special Projects NJ AIDS/STD Hotline Sexually Transmitted Disease Services (609) Tuberculosis Services (609) Visit the New Jersey Department of Health and Senior Services website: To request to have this report link ed to you, to be added to our mailing list, or to request other information, contact us by telephone or by . Telephone (609) aids@doh.state.nj.us Questions? Contact New Jersey HIV/AIDS Hotline

3 Highlights 3 By June 30, 2011, 35,841 people were reported living with HIV or AIDS in New Jersey. Minorities account for 76% of adult/adolescent cumulative (ever reported to the state) HIV/AIDS cases and 78% of all persons living with HIV/AIDS (Page 6). Injection drug use and sexual contact remain the major modes of exposure to HIV infection. The proportion of reported cases with HIV/AIDS who were exposed through injection drug use (IDU) is lower than in the past, while the proportion of cases that were exposed through sexual contact is increasing (Page 7). Seventy-nine percent of persons living with HIV/AIDS are 40 years of age or older (Page 10). Thirty-four percent of those living with HIV/AIDS are females; 58% of females living with HIV are currently years old. The number of annual pediatric infections has dropped over 90% since 2000 (page 11). Nearly 7,000 HIV/AIDS patients received medications through the state s AIDS Drug Distribution Program (ADDP) in 2010 (page 12). Table 12 shows HIV prevention services funded by the NJDHSS in 2010 (Page 13). In 2010 over 105,000 HIV tests were administered through Counseling and Testing Sites (page 14). The verification of a rapid HIV test with another rapid HIV test is addressed on page 15. Special Features The centerfold map features a complete reporting of HIV/AIDS cases, pediatric HIV/AIDS infections, and perinatal exposure by county. Cumulative case counts are based on patient residence at time of diagnosis, while counts of persons currently living with HIV/AIDS are based on most recently updated New Jersey address, regardless of where they were first diagnosed with HIV/AIDS. Copies of this report are available on the NJDHSS website at The website also contains complete county and municipal reports.

4 4 MISSION STATEMENT The Division s mission is to prevent and reduce the spread of HIV, STDs and TB and ensure that HIV-, STD- and TB- infected people and those at risk of infection have access to the care they need. The Division uses its resources to help community-based networks deliver high-quality, comprehensive services that meet the language and cultural needs of the people they serve. Introduction The purpose of this report is to provide data that can be used for monitoring the epidemic and for planning services and prevention activities. All data in this report are based on cases that were reported to the Division of HIV, STD and TB Services (DHSTS) through June 30, A description of how these data are collected can be found in the June 2002 HIV and AIDS Surveillance Report. This is available on the NJDHSS website at If you would prefer to receive this report by contact us at aids@doh.state.nj.us and we will you a link to the report. Epidemiology What can I find in this report? Adult/Adolescent HIV/AIDS cases in each age group, in each racial/ethnic group, and for each HIV/AIDS exposure category by gender for the most recent year, as well as cumulatively. These tables show all adult/adolescent persons reported with HIV infection including those who have progressed to AIDS whether living or deceased. As new therapies become available, a larger percentage of cases will remain HIV positive for longer periods of time before developing AIDS. Looking at both HIV and AIDS status provides a more complete picture of the history of infection in the state than does data about AIDS alone. It is also important to note that cases reported in the past 12 months may have been diagnosed in previous years, but due to data transmission were only recently tabulated. Persons living with HIV or AIDS for each gender by age group, in each racial/ethnic group, and for each exposure category. These persons are currently living in New Jersey regardless of where they were first diagnosed with HIV/AIDS. These data show where the epidemic is now and where services are most needed.

5 5 Pediatric HIV/AIDS and Exposures These data show the number of individuals diagnosed while under the age of 13. The data include information on perinatal exposures and other pediatric infections. HIV Prevention, Care and Treatment Services Updated data is presented for services provided through state funding, the Ryan White CARE Act, and the CDC funded HIV Prevention Cooperative Agreement. Modified Risk Exposure Hierarchy Although we usually cannot determine exactly how or when a person was infected, it is possible to determine which behaviors exposed an individual to HIV infection. In the 1980s the Centers for Disease Control and Prevention (CDC) established a hierarchy to categorize modes of exposure for persons reported with AIDS based on their risk exposures. Behaviors most likely to lead to infection are higher in the hierarchy than those less likely to lead to infection. This hierarchy is described at Beginning in the June 2004 report, we began to use a modified risk hierarchy. Heterosexual contact with a person of unknown status was reported as heterosexual contact with partners of unknown HIV risk. Prior to that, these cases were reported as persons with unknown risk exposure. Heterosexual contacts with persons of known risk are reported by the risk status of the partner. Due to improvements in the screening of donated blood, transfusions have been virtually eliminated as an exposure category for HIV infection. In this report, transfusion and hemophilia cases are reported in the Other/Unknown category. The ascertainment of exposure category is incomplete, especially for cases reported recently. Some cases currently in the Other/Unknown category may be categorized later to known exposure categories as follow-up investigations are completed. What won t this report tell me? Due to delays between diagnosis of HIV or AIDS and reporting to the DHSTS, cases reported during the last 12 months may have been diagnosed in previous years. Also, many cases diagnosed in 2010 and 2011 may not be in this report. It is also important to note that individuals who are infected but not tested and diagnosed are not included in these reports. It is estimated that undiagnosed and unreported cases comprise 21% of all estimated infections. The number of persons living with HIV/AIDS is only an estimate because of incomplete mortality data due to delays in reporting deaths of HIV/AIDS cases, and migration in or out-of-state. Therefore, the reported data underestimate true incidence, prevalence and mortality rates.

6 6 RACE/ETHNICITY DATA Table 1. New Jersey Adult/Adolescent HIV/AIDS Cases Reported July June 2011 (1) and Cumulative Totals as of June 30, 2011 Racial/Ethnic Group by Gender MALE FEMALE TOTAL Percentage July Cumulative July Cumulative July Cumulative of Cumulative Adults/ June 2011 Total June 2011 Total June 2011 Total Cases Who Adolescents (2) No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) Are Female White % 14,048 27% 51 10% 3,879 17% % 17,927 24% 22% Black % 26,393 51% % 15,007 65% 1,005 53% 41,400 55% 36% Hispanic % 10,615 21% % 3,956 17% % 14,571 20% 27% Asian/Pac. Isl. 27 2% 335 1% 5 1% 114 0% 32 2% 449 1% 25% Other/Unknown 0 0% 176 0% 2 0% 93 0% 2 0% 269 0% 35% Total 1, % 51, % % 23, % 1, % 74, % 31% (1) Includes every new report of HIV infection received during the 12 month period, regardless of stage of disease (HIV or AIDS) at time of first report. (2) Includes all patients 13 years of age or older at time of first diagnosis. Patients with missing specific age at diagnosis were not included. Note: Percentages may not add to 100 due to rounding. Race/Ethnicity Table 2. New Jersey Residents Living with HIV/AIDS as of June 30, 2011 Racial/Ethnic Group by Gender Percentage MALE FEMALE TOTAL of Prevalent Cases Who No. (%) No. (%) No. (%) Are Female White 5,965 25% 1,954 16% 7,919 22% 25% Black 11,471 49% 7,760 63% 19,231 54% 40% Hispanic 5,685 24% 2,406 20% 8,091 23% 30% Asian/Pac. Isl % 95 1% 364 1% 26% Other/Unknown 150 1% 86 1% 236 1% 36% Minorities account for 76% of the cumulative adult/adolescent HIV/AIDS cases. Thirty-one percent of the cumulative HIV/AIDS cases are women. Total 23, % 12, % 35, % 34% Note: Percentages may not add to 100 due to rounding. Figure 1. Percent Living with HIV/AIDS by Race/Ethnicity Over half of persons living with HIV/AIDS are non- Hispanic Blacks. Hispanic 23% Oth/Unk 1% White 22% Thirty-four percent of those living with HIV/AIDS are females. Four out of five females living with HIV/AIDS are minorities. Black 54%

7 HIV EXPOSURE CATEGORY DATA 7 Table 3. New Jersey Adult/Adolescent (1) HIV/AIDS Cases Reported July June 2011 (2) and Cumulative Totals as of June 30, 2011 Modified Exposure Category by Gender MALE FEMALE TOTAL July Cumulative July Cumulative July Cumulative Modified Exposure June 2011 Total June 2011 Total June 2011 Total Category (3) No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) MSM (4) % 15,241 30% 0 0% 0 0% % 15,241 20% 0% IDU (4) 53 4% 18,999 37% 29 6% 8,580 37% 82 4% 27,579 37% 31% MSM/IDU 22 2% 2,322 5% 0 0% 0 0% 22 1% 2,322 3% 0% Heterosexual contact with partner(s): - injection drug user 12 1% 901 2% 12 2% 2,840 12% 24 1% 3,741 5% 76% - bisexual male 0 0% 0 0% 4 1% 203 1% 4 0% 203 0% 100% - HIV infection, risk Other/Unknown 75 5% 3,382 7% 73 15% 4,939 21% 148 8% 8,321 11% 59% -partner(s) of unknown HIV risk (5) % 6,071 12% % 4,722 20% % 10,793 14% 44% Other/Unknown (6) % 4,651 9% % 1,765 8% % 6,416 9% 28% Total number of individuals 1, % 51, % % 23, % 1, % 74, % 31% (1) Includes all patients 13 years of age or older at time of diagnosis. Patients with missing specific age at diagnosis were not included. (2) Includes every new report of HIV infection received during the 12 month period, regardless of stage of disease (HIV or AIDS) at time of first report. (3) Cases with more than one risk factor, other than the MSM/IDU combination listed in the table, are tabulated only in the group listed first. The heterosexual contact exposure category has been modified to include contact with partners of unknown HIV risk (see note 5). (4) MSM = male-to-male sex. IDU = injection drug use. (5) Includes patients with no other risk identified who had heterosexual contact with partner(s) whose HIV infection risk is undocumented/unknown. (6) Includes patients who received transfusion, transplant or hemophilia treatment, whether or not blood products were documented to be HIV infected; patients with pediatric HIV exposures; and patients with no reported HIV exposure. Note: Percentages may not add to 100 due to rounding. Table 4. New Jersey Residents Living with HIV or AIDS as of June 30, 2011 Modified Exposure Category by Gender Modified MALE FEMALE TOTAL % of Exposure Cases Category (1) No. (%) No. (%) No. (%) Female MSM (2) 8,001 34% 0 0% 8,001 22% 0% IDU (2) 5,071 22% 2,879 23% 7,950 22% 36% MSM/IDU 783 3% 0 0% 783 2% 0% Heterosexual contact with partner(s): - injection drug user 377 2% 1,254 10% 1,631 5% 77% - bisexual male 0 0% 128 1% 128 0% 100% - HIV infection, risk Other/Unknown 2,035 9% 3,154 26% 5,189 14% 61% -partner(s) of unknown HIV risk(3) 4,027 17% 3,405 28% 7,432 21% 46% Other/Unknown (4) 3,246 14% 1,481 12% 4,727 13% 31% Total number of individuals 23, % 12, % 35, % 34% (1) Cases with more than one risk factor, other than the MSM/IDU combination listed in the table, are tabulated only in the group listed first. The heterosexual contact exposure category has been modified to include contact with partners of unknown HIV risk (see note 3). (2) MSM = male-to-male sex. IDU = injection drug use. (3) Includes patients with no other risk identified who had heterosexual contact with partner(s) whose HIV infection risk is undocumented/unknown. (4) Includes patients who received transfusion, transplant or hemophilia treatment, whether or not blood products were documented to be HIV infected; patients with pediatric HIV exposures; and patients with no reported HIV exposure. Note: Percentages may not add to 100 due to rounding. % of Cum. Cases Female Thirty-seven percent of all cumulative adult/adolescent HIV/AIDS cases were exposed by IDU, 30% by heterosexual contact, and 20% by male-to-male sex. Only 9% of cumulative cases (and 30% of cases recently reported in the last 12 months) had no reported risk or their risk is unknown.

8 CASES OF HIV/AIDS AND PERINATAL HIV EXPOSURE REPORTED AS OF JUNE 30, Statewide Summary Case Counts AIDS: 55,131 HIV: 20,845 H&A: 75,976 Living: 35,841 PedsInf: 1,360 PeriExp: 4,517 Somerset AIDS: 728 HIV: 263 H&A: 991 Living: 560 PedsInf: 21 PeriExp: 54 Mercer AIDS: 1750 HIV: 795 H&A: 2545 Living: 1438 PedsInf: 40 PeriExp: 192 Warren AIDS: 140 HIV: 63 H&A: 203 Living: 153 PedsInf: 4 PeriExp: 14 Hunterdon AIDS: 181 HIV: 65 H&A: 246 Living: 152 PedsInf: 4 PeriExp: 14 Sussex AIDS: 177 HIV: 88 H&A: 265 Living: 163 PedsInf: 7 PeriExp: 17 Morris AIDS: 1009 HIV: 394 H&A: 1403 Living: 800 PedsInf: 23 PeriExp: 58 Passaic AIDS: 4423 HIV: 1550 H&A: 5973 Living: 2575 PedsInf: 103 PeriExp: 440 Monmouth AIDS: 2646 HIV: 968 H&A: 3614 Living: 1783 PedsInf: 72 PeriExp 240 Bergen AIDS: 2392 HIV: 850 H&A: 3242 Living: 1567 PedsInf: 46 PeriExp: 115 Essex AIDS: HIV: 6246 H&A: Living: 9669 PedsInf: 465 PeriExp: 1509 Hudson AIDS: 8053 HIV: 2615 H&A: Living: 4590 PedsInf: 192 PeriExp: 558 Union AIDS: 4173 HIV: 1351 H&A: 5524 Living: 2688 PedsInf: 99 PeriExp: 324 Gloucester AIDS: 433 HIV: 216 H&A: 649 Living: 395 PedsInf: 8 PeriExp: 27 Camden AIDS: 2085 HIV: 979 H&A: 3064 Living: 1736 PedsInf: 44 PeriExp: 204 Salem AIDS 214 HIV: 101 H&A: 315 Living: 158 PedsInf 5 PeriExp: 45 Cumberland AIDS: 656 HIV: 267 H&A: 923 Living: 537 PedsInf: 16 Legend for Summary Case Counts PeriExp: 109 AIDS = AIDS cases (cumulative) HIV = HIV Positive Cases, not AIDS H&A = HIV/AIDS Cases (cumulative, NJ residents at diagnosis) Living = Persons Living with HIV/AIDS (HIV/AIDS cases not known dead, currently living in NJ) PedsInf = Pediatric Infections (Child diagnosed with HIV infection; included in HIV/AIDS case counts) PeriExp = Perinatal HIV Exposures (Child born to HIV+ mother, child s HIV serostatus is negative or indeterminate; NOT included in HIV/AIDS case counts) Burlington AIDS: 828 HIV: 396 H&A: 1224 Living: 748 PedsInf: 15 PeriExp: 58 Atlantic AIDS: 1940 HIV: 898 H&A: 2838 Living: 1398 PedsInf: 25 PeriExp:159 Ocean AIDS: 984 HIV: 373 H&A: 1357 Living: 696 PedsInf: 27 PeriExp: 70 Cape May AIDS: 295 HIV: 123 H&A: 418 Living: 193 PedsInf: 5 PeriExp: 38 Middlesex AIDS: 3095 HIV: 999 H&A: 4094 Living: 2042 PedsInf: 80 PeriExp: 248 Cases not on map County Unk/Undetermined Incarcerated in New Jersey AIDS: 40 2,766 HIV: 123 1,122 H&A: 163 3,888 Living: 15 1,785 PedsInf: 58 1 PeriExp:

9 10 AGE GROUP DATA Table 5. New Jersey Adult/Adolescent HIV/AIDS Cases Reported July June 2011 (1) and Cumulative Totals as of June 30, 2011 Age at Diagnosis by Gender MALE FEMALE TOTAL Percentage July Cumulative July Cumulative July Cumulative of Known Age at June 2011 Total June 2011 Total June 2011 Total Cumulative Diagnosis Cases Who No. (%) No. (%) No. (%) No. (%) No. (%) No. (%) Are Female % 599 1% 25 5% 536 2% 72 4% 1,135 2% % 9,041 18% % 5,503 24% % 14,544 19% % 21,369 41% % 9,735 42% % 31,104 42% % 14,285 28% % 5,055 22% % 19,340 26% Over % 6,273 12% % 2,220 10% % 8,493 11% Total 1, % 51, % % 23, % 1, % 74, % (1) Includes every new report of HIV infection received during the 12 month period, regardless of stage of disease (HIV or AIDS) at time of first report. Note: Percentages may not add to 100 due to rounding. Table 6. New Jersey Residents Currently Living with HIV/AIDS as of June 30, 2011 Current Age by Gender Percentage Current MALE FEMALE TOTAL of Prevalent Age Cases Who No. (%) No. (%) No. (%) Are Female 47% 38% 31% 26% 26% 31% % 49 0% 96 0% % 193 2% 378 1% ,525 6% 705 6% 2,230 6% ,012 13% 1,885 15% 4,897 14% ,914 34% 4,505 37% 12,419 35% Over 49 10,857 46% 4,964 40% 15,821 44% Total 23, % 12, % 35, % Figure 2. Percentage Living with HIV/AIDS by Age Group < 30yrs 7% yrs 14% 51% 51% 32% 38% 36% 31% 34% Recently reported cases of adult/adolescent HIV and AIDS are older at diagnosis than previously reported cases. Seventy-nine percent of those living with HIV or AIDS are 40 years of age or older. Over 49 yrs 44% yrs 35% Thirty-four percent of those living with HIV/AIDS are females. Fifty-eight percent of females living with HIV/AIDS are currently years old.

10 PEDIATRIC DATA 11 Table 7. New Jersey Pediatric (1) Cumulative HIV and AIDS Cases Exposure Category (2) by Race/Ethnicity - As of June 30, 2011 Mode of Transmission (2) White Black Hispanic Other/Not Reported Total Mother With/At Risk of HIV (3) ,265 Hemophilia/Coagulation Disorder Transfusion/Blood Components Risk Not Reported/Other Risk Total ,360 % Perinatally Infected 83% 95% 93% 60% 93% (1) Includes all patients under 13 years of age at time of HIV infection, who were New Jersey residents or diagnosed in New Jersey. (2) Cases with more than one risk, other than the combinations listed, are tabulated only in the risk group listed first. (3) Epidemiologic data suggest transmission from an infected mother to her fetus or infant during the perinatal period. Birth Infected (2) Indeterminate (3) Seroreverter (4) Total Reported Year No. (%) No. (%) No. (%) No % % 1,241 55% 2, % 74 26% % % 64 29% % % 64 27% % % 55 27% % % 75 34% % % 56 29% % % 41 23% % % 43 25% % % 54 28% % % 55 34% % * 4 3% 78 50% 74 47% * 2 2% 61 97% 0 0% 63 (1) Exposure - Child was exposed to HIV during pregnancy/delivery. (2) Infected - Child is infected with HIV/AIDS. (3) Indeterminate - Child was exposed but actual status of infection is unknown. (4) Seroreverter - Child was perinatally exposed and proven to be uninfected. * Years 2010 and 2011 data are incomplete Table 9. New Jersey Pediatric Cases Living with HIV/AIDS (1) by Race/Ethnicity and Current Age Race/Ethnicity Table 8. New Jersey Born HIV Pediatric Exposures (1) by Current Status and Year of Birth for Children Born As of June 30, 2011 June 30, 2011 Current Age < 5 Yrs Yrs. >= 13 Yrs. Total No. (%) No. (%) No. (%) No. (%) White 0 0% 10 9% 90 14% % Black 10 83% 77 67% % % Hispanic 2 17% 27 23% % % Other 0 0% 1 1% 2 0% 3 0% Perinatal transmission was reduced to two percent in Eighty-four percent of living individuals infected as children since the 1980's are now adults/adolecsents, 13 years or older. Eighty-seven percent of pediatric cases living with HIV/AIDS are minorities. Total 12 2% % % % (1) Living Pediatric HIV/AIDS cases who were New Jersey residents or diagnosed in New Jersey.

11 12 Table 10. Ryan White Part B Services in Calendar Year 2010 Program Area Type of Service Clients Served AIDS Drug Distribution medications 6,993 Program Health Insurance health insurance premiums 515 Continuation Program Home Care Program home health services 84 Access to Care care outreach 62 Core Health Services outpatient/ambulatory medical care 2,272 dental care 487 treatment adherence counseling 2,343 mental health services 617 substance abuse services 80 nutritional counseling 417 Support Services case management 4,093 short-term/emergency housing assistance 29 medical transportation services 1,287 residential substance abuse services 5 Table 11. DHSTS Care and Treatment Services in Calendar Year 2010 Program Source of Funding Clients Served Early Intervention Programs State 5,221 Housing Opportunities for HUD 236 Persons with AIDS

12 13 PREVENTION Table12. Summary of Major HIV/AIDS Prevention Interventions Funded Agencies and Client Numbers by Target Population for 2010 Type of Intervention Populations Targeted/Reached Individual Outreach MSM IDU Heterosexual HIV Positive Number of Agencies Providing Services Number of Clients Served* 1,333 1,355 7, Interventions delivered to Individuals MSM IDU Heterosexual HIV Positive Youth Number of Agencies Providing Services Number of Clients Served Interventions delivered to Groups MSM IDU Heterosexual HIV Positive Youth Number of Agencies Providing Services Number of Clients Served , Comprehensive Risk Counseling Services MSM IDU Heterosexual HIV Positive Youth Number of Agencies Providing Services Number of Clients Served * Total number of individual client outreached is reported aggregately and Risk Categories listed are not mutually exclusive. MSM are not included with heterosexual males. Clients outreached under Social Marketing programs are not included. The DHSTS provides partner counseling and referral services to HIV positive clients in the state through the Notification Assistance Program (NAP). They notify the sex or needle-sharing partners of HIV infected individuals that have been elicited by providers of the fact that they have been exposed to HIV. They offer them HIV counseling and testing, and if HIV positive, elicit the names of their partners for this service. This is done because these partners may be infected and not know it, may be infecting others, and may benefit from treatment. The service is confidential, and the individual who named the partner is never revealed. The NAP staff also provides test results to persons who test HIV positive but fail to return for results. If you would like to refer individuals to the NAP for partner counseling you can call (877) toll free. Table 13. Notification Assistance Program Services Provided in 2010 Partners Referred/Elicited (1) Partners Tested Partners Testing HIV Positive HIV+ Clients Counseled (1) Referred partners are those that are elicited by providers and assigned to the NAP to contact. Elicited partners are those that the NAP staff identifies when they counsel HIV positive individuals

13 14 SITE TYPE HIV Counseling and Testing Table 14. Publicly Funded HIV Counseling and Testing Activities January - December 2010 (Data reported as of August 4, 2011) NUMBER TESTED¹ PERCENT OF TOTAL TESTED TESTED POSITIVE PERCENT POSITIVE HIV CTS 2 34, % % Hospital/Emergency Dept. 20, % % Outpatient Facilities 2, % % STD Clinic 9, % % Correctional Facility 6, % % Community Setting 8, % % TB Clinic 1, % % Drug Treatment Center 4, % % Family Planning Clinic 17, % % Prenatal Clinic % % Blood Bank, Plasma Center % % GENDER Male 50, % % Female 53, % % Transgender -M2F % % Transgender F2M % % Unknown(Uncoded) % % ETHNICITY Hispanic 31, % % Not Hispanic 70, % % Don't Know % % Declined % % Unknown (Uncoded) 2, % % RACE 3 AM Indian/AK Native % % Asian 1, % % Black or African American 50, % % Native Hawaiian/Pacific Islander 2, % % White 41, % % Don't Know 4, % % Declined % % Unknown (Uncoded) 4, % % AGE < % % , % % , % % , % % , % % 50+ 9, % % Unknown(Uncoded) % % TOTAL 105, % % 1. Numbers do not represent individuals as clients may be tested more than once. 2. HIV/CTS sites are clinic, whose primary purpose is HIV counseling and testing. 3. Clients could be multiple Race. PEMS forms do not have Hispanic/Non-Hispanic broken down by race.

14 15 Rapid HIV Testing Update: Verification of a Rapid HIV Test with a Rapid HIV Test Verification of a rapid HIV test with another rapid HIV test was started as an approach to improve receipt of results for those testing positive and the ability to do contact elicitation and referrals. Because persons with a reactive rapid test need to return for Western blot (WB) results, the New Jersey Department of Health and Senior Services (NJDHSS), Division of HIV, STD and TB Services (DHSTS) found that approximately 25% of those testing positive did not return for results. Although referred to the DHSTS Notification Assistance Program (NAP) for follow-up, NAP only located 20% of these individuals. Retrospective studies by the DHSTS and Robert Wood Johnson Medical School (RWJ) have shown that a rapid-rapid algorithm accurately detects infection and would decrease the number of false positive results provided to patients. The DHSTS and RWJ staff are on the Association of Public Health Laboratories (APHL), Centers for Disease Control and Prevention (CDC) committee that is developing point-of-care rapid-rapid algorithms. Verification of a rapid HIV test with another rapid HIV test is done internationally. The DHSTS started verification of a rapid HIV test with another rapid HIV test on December 10, 2008, at selected DHSTS-funded HIV counseling and testing sites. The selection was based on HIV prevalence at the counseling and testing site. The current algorithm is to do a rapid HIV test. If it is reactive, a second rapid HIV test (from another manufacturer) is done. If both rapid tests are reactive, contact elicitation and referral for treatment, prevention, and social services are completed. A WB is currently done to assure us that verifying a rapid test with another rapid test is an appropriate algorithm for the DHSTS-funded sites. During December 2008 to July 31, 2011, 24 facilities doing rapid-rapid testing performed 70,362 tests. To date, 590 reactive (preliminary positive) HIV tests were obtained with 554 (93.9%) verified with a second different rapid HIV test; of these rapid-rapid positive patients, 404 (72.9%) connected to healthcare providers (appointment arranged) at the time the second rapid test was performed. Of the 590 preliminary positive results, Western blot testing confirmed 518 of the preliminary positive results. Overall, 38 discordant results have been identified. Of this total, 30 discordant results were associated with a false positive initial rapid test and eight were associated with a negative second rapid test. Tests identified as discordant are resolved by additional testing: Nucleic Acid Amplification Test (NAAT), enzyme immunoassay (EIA) and Western blot (WB) follow-up. The percentage of persons receiving their results and referrals for treatment, prevention, and social services has increased dramatically with rapid-rapid HIV testing. In addition, contact elicitation is able to be completed. Expansion to other counseling and testing sites and other counties is on-going.

15 For More Information go to the Division of HIV, STD and TB Services Website at: or call the New Jersey Department of Health and Senior Services Division of HIV, STD and TB Services Epidemiologic Services Unit at (609)