The purpose of this surveillance initiative will be to provide information that is necessary for developing and implementing effective interventions for linking prevention, treatment and care, and encouraging the use of these services by HIV-infected persons who are not receiving care in New Jersey. Specifically, the New Jersey Department of Health and Senior Services, Division of HIV/AIDS Services, will 1) identify persons who have a diagnosis of HIV, but who are not receiving care, 2) ascertain barriers to receiving care through patient interview, and 3) determine the clinical status of persons who have a diagnosis of HIV infection, but who are not receiving care, and 4) to estimate the added resources that will be required when these individuals are linked to care. This is consistent with the Division's mission """"""""...to prevent, treat, and reduce the spread of HIV in New Jersey. In keeping with this mission, the DHAS will monitor the epidemic, and assure through its resources that individuals who are at risk or infected with HIV have access to culturally competent, community-based networks that provide qualitative and comprehensive services."""""""" Clients will be identified as not receiving medical care by database matches of the HIV/AIDS registry with databases of laboratory (CD4 and viral load) data, prescription drug data, and medical services. A random sample of known HIV-infected persons with no matching laboratory or clinical data will be selected and contacted for personnel interview to determine factors related to their not seeking care. Blood will be collected from consenting participants for laboratory testing including HIV viral loads, CD4 counts, and resistance testing to assess their clinical status. Participants will receive information on available prevention and care services. This is relevant to public health because it increases the capacity to monitor the epidemic, assists in developing interventions to stop the spread of disease, and identifies actions needed to reduce barriers to care. Determining the factors that affect an HIV-infected individual's decision not to receive care will strengthen efforts to get more people into care, reduce disease progression, and subsequently reduce HIV transmission.
