oday, Dr. Martin and Gratian Salaru, MD, associate professor of pathology and laboratory medicine, serve as codirectors of the New Jersey HIV program, with a goal to move New Jersey’s rapid HIV testing forward. Their work has made a significant impact. “We screen between 70,000 and 80,000 people every year,” says Dr. Martin. “That’s getting close to a million people we’ve screened since we started this program 12 years ago.” Over that time, he says, the program has identified 700 to 800 people per year who are HIV infected. “But the thing that makes such a difference is that we now have treatments that effectively keep people from the ravages of AIDS,” says Dr. Salaru. As a result, HIV-infected people can live an almost normal life. t STEVE HOCKSTEIN o A Model for Change fficials in other states are now looking to the New Jersey Rapid HIV Testing Program as a model of HIV screening. “We hear from Michigan, Minnesota, California, Arizona, and even St. Thomas and St. Croix in the Caribbean,” says Dr. Martin. “Our algorithm approach is especially valuable to low-resource communities.” The program has earned national honors. The Association of State and Territorial Health Officials recognized the Rapid HIV Testing Program with two Vision Awards—one in 2006 for the model itself and one in 2013 for the HIV Prevention Patient Navigator Program associated with it. “The thing that makes such a difference is that we now have treatments that effectively keep people from the ravages of AIDS,” says Gratian Salaru, MD, associate professor of pathology and laboratory medicine (above), who codirects the New Jersey HIV Program with Eugene Martin, PhD, professor of pathology and laboratory medicine (right). an opportunity to get involved, only one test kit, the Orasure OraQuick Rapid HIV Test, was approved for use in the United States. “Worldwide, rapid HIV testing was well under way in locations with high HIV prevalence and limited resources—the World Health Organization had been doing rapid HIV testing with a number of rapid HIV tests for nearly 10 years,” says Dr. Salaru. The cost of licensing a test in the United States was a source of frustration and viewed as a prohibitive barrier to many manufacturers until the CDC recognized the need to provide alternative pathways for HIV testing, particularly within the public health community. Reaching the right population was and continues to be another stumbling block. The program targets mostly lowincome people—all those who are medically underserved. Educating those who don’t think they are at risk isn’t easy. “We want to test as many people as we can—you can’t treat unless you know,” says Dr. Martin. The State and Medical School Partnership stablished in 2004, the partnership between the state and Robert Wood Johnson Medical School was a natural one. New Jersey requires laboratory licensure for many tests, including HIV. All rapid HIV tests require a quality assurance program. Initially, the state Department of Health reached out to Dr. Cadoff, looking for a collaborative partner who could assist with the original CDC initiative and provide quality assurance oversight to a community-based rapid HIV testing program. Because the medical school had a multifacility testing capability, the partnership made sense. It started with one site, then grew to four, then six. It now includes more than 100 licensed facilities offering rapid HIV testing—all of which are overseen by a quality assurance program. e The Initiative and Its Challenges ome roadblocks involved logistics and materials. Some continue to surround motivating and educating the target audience. When the state offered the medical school 14 Robert Wood Johnson I MEDICINE s Linking People to Care within Two Days t he team has approached testing by pairing it hand in hand with clinical service providers, overlapping sup-