Effective HIV prevention interventions have been proven to reduce HIV transmission. People who get tested for HIV and learn that they are infected can make significant behavior changes to improve their health and reduce the risk of transmitting HIV to their sex or drug-using partners. Recent scientific advances have demonstrated that early initiation of antiretroviral therapy (ART) not only preserves the health of people living with HIV but also reduces their risk of transmitting HIV to others.¹

2018-2023

HIV continues to be an epidemic in New Jersey.  New Jersey has one of the highest estimated proportions of women living with HIV in the United States. Of new cases diagnosed in 2021 with a documented exposure category, over 90% of cases reported sexual contact as the mode of exposure to the HIV infection.  The proportion of persons exposed through injection drug use (IDU) is lower than in the past.

Projects

The mission of the Department's Division of HIV, STD, and TB Services (DHSTS) is to prevent and reduce the spread of HIV, STDs, and TB and to ensure that those infected and at risk of infection have access to the care they need. The DHSTS provides HIV counseling at local testing sites, administers the Rapid HIV Testing Program which is used to diagnose patients, and administers the AIDS Drug Distribution Program (ADDP) which provides life supporting and life sustaining medications. Free, confidential testing and treatment for STDs is made available throughout the state as well.

The Department has implemented a harm reduction program with the goal of stopping the spread of injection-related diseases through prevention programs including increasing access to supplies and providing necessary referrals to support services.

Policies

• N.J.A.C. 8:65 HIV Infection Reporting requires health care providers, counseling and testing sites, and clinical laboratories to report HIV infection diagnoses and HIV-related laboratory test results and specifies the reporting procedures and mandatory content of laboratory order and specimen submission forms.

• N.J.A.C. 8:61 AIDS Drug Distribution Program (ADDP) gives the clinical and financial criteria which individuals must meet in order to become enrolled in the ADDP.

• N.J.A.C. 8:63 Harm Reduction Services gives the process by which the Department is able to authorize agencies to provide harm reduction services within New Jersey.

  In 2021, NJDOH released New Jersey’s Strategic Plan to End the HIV Epidemic by 2025 which aims to:
  • Reduce the number of new HIV infections by 75%.
  • Promote access to testing so 100% of individuals living with HIV/AIDS know their status.
  • Promote access/linkage to care so 90% of those diagnosed with HIV/AIDS are virally suppressed.

• New Jersey signed on to the Undetectable = Untransmittable (U=U) campaign in 2018.

Legislation

On January 18, 2022, several important legislation bills were passed and signed into law, including:

• P.L.2021, c.409 repeals the statute that criminalizes sexual penetration while infected with a venereal disease or HIV under certain circumstances. Additionally, the bill requires that in prosecutions for endangering another by creating substantial risk of transmitting infectious disease, the name of the defendant and other individual be kept confidential. 
• P.L.2021, c.396 authorizes expanded provision of harm reduction services to distribute sterile syringes and provide certain support services to persons who use drugs intravenously.
• P.L.2021, c.403 permits expungement of possession or distribution of hypodermic syringe or needle offense in cases of previous expungement; repeals criminal offense of possession of syringe.

Outreach

• NJDOH’s Division of HIV, STD, and TB Services (DHSTS), in conjunction with Rutgers University – Robert Wood Johnson Medical School maintains a readily accessible statewide network of 100 HIV test sites, at which individuals may obtain free and confidential rapid HIV testing to both decrease the estimated percentage of New Jerseyans unaware of their HIV infections and increase the proportion of persons living with HIV (PLWH) linked to HIV care. Each year, the program tests approximately 60,000 persons. Test site locations are continuously monitored to ensure significant yields of positive test results and are geographically situated based on HIV prevalence data supplied by the DHSTS HIV Surveillance Program.  HIV Testing is available in a variety of venues, including opt-out testing in health care settings such as emergency departments, primary care clinics, STD clinics, federally qualified health centers, local health departments, and even a dental clinic. 
• New Jersey Pre-Exposure Prophylaxis (PrEP) Navigator Program is an initiative designed to provide status neutral support to individuals seeking access to PrEP for HIV prevention. The state actively funds 38 agencies that can house one to four navigators depending on the needs of the community. Navigators assist individuals seeking PrEP in navigating the health care system, overcoming barriers, and connecting them with appropriate resources to ensure that they can successfully initiate and adhere to PrEP.
• A Community Health Worker (CHW) is a frontline public health worker who is a trusted member of and/or has an in-depth understanding of the community served in providing emotional, informational, instrumental, and social (affiliation) support.  Currently, DHSTS supports 24 positions. CHWs facilitate communication with medical staff for their client’s needs and share personal experiences that they have encountered along the way to empower their clients.  
• The Housing Opportunities for People with AIDS (HOPWA) Program is supported by funding from the U.S. Department of Housing and Urban Development. This funding allows NJDOH to assist persons living with HIV with access to safe and sanitary housing in the private rental market. Hyacinth was approved and funded through a RFA process for both HOPWA programs (general housing assistance and the post-incarceration housing assistance) in April 2024 and have begun the process of providing housing assistance to PLWH.  
• The AIDS Drug Distribution Program (ADDP) provides free, life-sustaining, and life-prolonging HIV medications to low-income individuals who have no other means to pay for medicines. ADDP customers also receive other therapeutics that treat coinfections and other co-occurring conditions and illnesses. ADDP funds also provide premium assistance to enable ADDP customers to obtain health insurance coverage. Customers can purchase Marketplace policies and apply for ADDP-funded Health Insurance Premium Payment (HIPP) program for assistance. HIPP will then pay the premium on behalf of the customer. ADDP is supported by grant funds through the federal Ryan White Part B program.
  • To be eligible to participate in ADDP/HIPP a person must be New Jersey resident, have an HIV diagnosis, have a household income that does not exceed 500% of the federal poverty level, and have no other payment source for these services. 
  • As of April 30, 2023, ADDP enrolled 7,627 individuals, 904 of whom also receive premium assistance.  

Grants given by NJDOH

• In 2023, 107 grants totaling nearly $42.5 million were given to hospitals, federally qualified health centers (FQHCs), research institutions, local governments, and other organizations in New Jersey.

Grants received by NJDOH

• PS22-2201: National HIV Behavioral Surveillance (NHBS) supports ongoing national bio-behavioral surveillance to monitor HIV-related behaviors, detect changes over time in HIV risk behaviors among populations overburdened by HIV infections, and to inform and evaluate HIV prevention activities. It also aims to fill gaps in knowledge regarding HIV prevention priorities among populations in geographic areas where current data are limited. (January 2022 – December 2027)
• PS20-2005: Medical Monitoring Program (MMP) is a surveillance system designed to learn more about the experiences and needs of people who are living with HIV. MMP is unique in that it describes comprehensive clinical and behavioral information from persons carefully sampled to represent everyone diagnosed with HIV in the U.S. The data are collected through in-person or telephone interviews with participants as well as a two-year medical chart abstraction for all persons who have been in care. Because MMP’s estimates are designed to be locally and nationally representative, the information gathered from MMP may be used by prevention planning groups, policy leaders, health care providers, and people living with HIV to highlight disparities in care and services and to advocate for needed resources.(June 2020 – May 2025)
• PS20-2010: Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States supports the development and implementation of programs tailored to ending the HIV epidemic in the U.S.  Its purpose is to implement comprehensive HIV programs, that complement programs, such as the Ryan White program and other HHS programs, designed to support ending the HIV epidemic in America by leveraging powerful data, tools, and resources to reduce new HIV infections by 75% in 5 years.
• PS19-1906: Strategic Partnerships and Planning to Support Ending the HIV Epidemic in the United States supports strategic partnerships, communication, peer-to-peer technical assistance (TA), and jurisdictional planning efforts to address emerging needs of targeted jurisdictions through CDC-funded state and local health departments and their ability to the end the HIV epidemic in the U.S. (September 2019 – September 2024)
• PS18-1802: Integrated HIV Surveillance and Prevention Programs for Health Departments to implement a comprehensive HIV surveillance and prevention program to prevent new HIV infections and achieve viral suppression among persons living with HIV. (January 2018 – December 2022)
• HRSA-22-033: RyanWhite HIV/AIDS Program HIV Care Grant Program – Part B States/Territories Formula and AIDS Drug Assistance Program Formula and ADAP Supplemental Awards to assist states in developing and/or enhancing access to a comprehensive continuum of high-quality HIV care and treatment for low-income people with HIV (April 1, 2022 – March 31, 2027) and to supplement formula-based funding provided through the HIV Care Grant Program. (September 2020 – September 2029)

Challenges

• Continued HIV-related stigma, even with prevention tools like PrEP, exist both within communities and among health care providers.
• Mental health among persons infected with HIV remains a significant barrier to medication adherence that impacts viral suppression.

Disparities/Inequities

• HIV diagnoses among gay and bisexual men rose from 53 percent of all reported cases in 2010 to 64 percent of cases in 2020.
• HIV diagnoses continue to disproportionately affect minority communities in New Jersey with 80 percent of new infections in 2021 being reported among persons who identify as Black or Hispanic.
• Between 2010 and 2020, HIV infections reported among persons who inject drugs dropped from 8 percent to 4 percent in New Jersey.

Final Assessment

• Four of the five HIV/AIDS targets were achieved by 2020.
• The proportion of HIV+ persons achieving a suppressed viral load improved but the Healthy NJ 2020 target was not met.

For more information, please refer to these resources:

• NJDOH Division of HIV, STD, and TB Services
• CDC Division of HIV/AIDS Prevention
• HIV.gov
• Healthy People 2030

Reference:

1. HIV. Healthy People 2020. 10/8/20.