Ending the HIV Epidemic Newsletter
NASTAD, in collaboration with the National Association of County and City Health Officials (NACCHO), the Council of State and Territorial Epidemiologists (CSTE), and the National Coalition of STD Directors (NCSD), distributes a monthly newsletter to Phase 1 Ending the HIV Epidemic: A Plan for America (EHE) jurisdictions. The newsletter informs recipients of EHE-related policy updates, communications from federal partners, success stories, and other related EHE information. As the CDC PS19-1906 National Partner and HRSA-20-089 Systems Coordinator Provider recipients, NASTAD also launched an EHE website to house programmatic updates, share strategies and outcomes from Phase 1 jurisdictions, and connect health departments with the community. For questions, comments, or content contributions, please contact Mike Weir.
Hill Happenings
Fiscal Year 2024 Appropriations
The President’s budget will reveal Democrats’ spending priorities amid hardline Republican opposition to any spending increases and the GOP-led House of Republicans’ push to impose spending cuts in FY2024. Additionally, FY2024 spending discussions will be complicated by debt ceiling negotiations, which need to be resolved by June of 2023. NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs.
NASTAD and the AIDS Budget and Appropriations Coalition (ABAC) Highlight Essential HIV and Hepatitis Programs in FY2024
On March 6, NASTAD and the AIDS Budget and Appropriations Coalition (ABAC), a workgroup of the Federal AIDS Policy Partnership (FAPP), sent a letter to top appropriators highlighting the essential federal programs that coordinate HIV and viral hepatitis care across the country. The coalition emphasized the importance of achieving a bipartisan commitment to provide sufficient resources and implement proper policies in order to sustain science-based, public health prevention and treatment programs at federal agencies including the Department of Health and Human Services (HHS), the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), and National Institutes of Health (NIH) in FY2024.
Administration Updates
Fiscal Year 2024 Appropriations
On March 9, President Biden released the fiscal year 2024 (FY2024) Executive Budget Request to Congress, a non-binding budget proposal that lays out the Administration’s spending and policy priorities for FY2024 and sets the starting point for Congressional negotiations on the appropriations bills. The Biden Administration is proposing significant investments in public health, including a $237 million national PrEP program, a $11.3 billion national hepatitis C virus (HCV) elimination initiative, and a new $50 million Community Harm Reduction and Engagement Initiative.
The budget request included the following funding allocations:
Centers for Disease Control and Prevention
- Domestic HIV Prevention and Research - $1,099 million (+$113 m)
- HIV Prevention - $755.6 million (+ $0m)
- EHE Initiative - $310 million (+$90 m)
- School Health - $90.1 million (+$52 m)
- Viral Hepatitis - $54.5 million (+$11.5 m)
- Infectious Disease and the Opioid Epidemic - $23 million (+$0 m)
Health Resources and Services Administration
- Ryan White (EHE) – $2.696 billion (+$125 m)
- Ryan White Part B – $464.6 million (+$0)
- Ryan White Part B – ADAP - $900.3 million (+$0)
- Ryan White Part D - $77. 9 million (+$0)
- Ryan White EHE - $290 m (+$125 m)
- Community Health Centers (EHE) - $172.3 million (+$15m)
Substance Abuse and Mental Health Services Administration (SAMHSA)
- Community Harm Reduction and Engagement Initiative - $50 million (+$50 m)
Department of Housing and Urban Development (HUD)
- Housing Opportunities for Persons with AIDS (HOPWA) - $505 million (+6 million)
Department of Health and Human Services
- National PrEP Delivery Program - $237 million (mandatory)
- National HCV Elimination Initiative – $11.3 billion (mandatory)
- Minority HIV/AIDS Fund - $60 million (+$0 m)
Additionally, the SAMHSA budget justification document calls for the removal of the ban on federal funds to purchase syringes. Click here to read a NASTAD blog post that provides more details on the funding provisions included in the President’s Budget Request to Congress for FY2024.
The final FY2024 appropriations bills, however, will require bipartisan agreement on spending levels. Republicans in the House of Representatives have pledged to leverage their majority in the lower chamber to impose budget cuts as condition for supporting a bipartisan debt-limit fix, which complicates the viability of the landmark national PrEP and HCV elimination programs and will likely result in lower funding allocations than proposed in the President’s budget. NASTAD will continue to monitor the appropriations process and advocate for the highest funding level on behalf of HIV and hepatitis programs.
CDC Webinar: HIV Is Not a Crime: A Roundtable Discussion on Legal, Health & Equity Considerations Related to HIV Criminalization
In honor of HIV Is Not a Crime Awareness Day, ChangeLab Solutions and CDC held a webinar with experts on HIV law, policy, and research to discuss the importance of HIV decriminalization; CDC’s new HIV criminalization assessment tool; and the path toward a more equitable future. A recording of the webinar can be found here.
CDC Adopts Universal HBV Screening and Testing Recommendations
On March 9, the CDC published a Morbidity and Mortality Weekly Report (MMWR) that formally adopts updated screening and testing recommendations for hepatitis B virus (HBV). CDC now recommends universal HBV screening and testing for all adults in the United States at least once in their lifetime and expanded continual, periodic risk-based testing for populations that are at increased risk of HBV. The new screening and testing recommendations will support early diagnosis and linkage to care, facilitate greater detection of people living with chronic HBV, and serve as a key opportunity to inoculate unvaccinated adults. The new HBV screening and testing recommendations complement CDC’s 2022 HBV vaccination recommendations that were updated to include universal preventive HBV vaccination for all adults aged 19-59.
Broad patient and provider education will be required in order to effectively implement the recommendations. NASTAD members are strongly encouraged to notify critical stakeholders of the CDC’s updated adult HBV screening, testing, and vaccination recommendations and initiate planning for their immediate implementation. Additionally, click here to read a Dear Colleague Letter from Dr. Carolyn Wester, Director of the CDC Division of Viral Hepatitis on the significance of the universal HBV screening and testing recommendations, and click here to read a JAMA Viewpoint from the MMWR authors.
Help Improve America’s HIV Epidemic Analysis Dashboard (AHEAD)
“America’s HIV Epidemic Analysis Dashboard (AHEAD) is a data visualization tool to help you understand how priority EHE jurisdictions are doing. We need your help to make sure that AHEAD is doing its job to monitor the EHE jurisdictional progress while providing information on all 50 states and Puerto Rico!
We need your help to improve the efficacy, usability, and functionality of the Dashboard, and to let us know how AHEAD can better support your work. We’re looking for a few participants who are interested in:
- Filling out a short (5-minute) user feedback form
- Participating in a guided user testing activity, or
- Participating in an hour-long interview
Hearing from you will help us make sure that AHEAD is best meeting the needs of the community. No experience with the Dashboard? No problem! We’re also looking for new users who don’t have experience yet with AHEAD.
If you’re interested in participating, please contact our AHEAD Associate, Catarina Kim at Catarina.kim@hhs.gov.”
CDC’s NCHHSTP Equity Initiative
“In January 2023, the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) announced the NCHHSTP Equity Initiative. The initiative, which was put into practice in February 2021, is a transformational long-term strategy designed to achieve equity within the Center’s workplace and eliminate health disparities by addressing racism and other systems of oppression that hinder our mission. The Initiative builds on decades of successful work—by NCHHSTP staff, our partners, and advocates—giving us a strong foundation of proven strategies and bold ideas to advance equity.”
Resources
CEDIS program recruiting for experienced and newer DI professionals
The Coaching for Enhanced Disease Intervention Skills (CEDIS) program is accepting applications for a new cohort. The CEDIS program builds skills in interviewing, rapport-building, problem-solving, and cultural humility by matching experienced Disease Intervention (DI) professionals to newer DI professionals for an eight-week coaching program.
Newer DI professionals must be nominated by their health department to participate in the CEDIS program. To be nominated, DI professionals must be actively conducting STI and/or HIV DI work and have completed the onboarding and training required for their role. Experienced DI professionals working in health departments are encouraged to apply. Experienced DI professionals must have at least three years of current or prior frontline DI experience. Applications are due by Monday, April 3, 2023 and the cohort will begin in late April 2023.
For more information about how to apply and to register for an informational session, please visit http://jsi.com/cedis.
Imagine Campaign Resources in Spanish
Since the launch of the Imagine Campaign in June 2022, TAP-in intended to cultivate a campaign that provides immense value and is accessible to all EHE jurisdictions. TAP-in is excited to share that the Imagine: Ending HIV. It’s Possible campaign video is now available in Spanish.
Two factsheets are also available in Spanish:
- Encontrar y utilizar las mejores fuentes de información para apoyar las estrategias de la iniciativa “Terminando con la Epidemia de VIH” (EHE)
- Las pequeñas victorias conducen a un gran impacto
TAP-in also added a new tool: Top 5 Tips on How to Get Started with the Imagine Campaign. By following these tips, the Imagine Campaign will help you, along with other jurisdictions, build excitement and maintain momentum to achieve the EHE goals. Campaign talking points, a printable “Join Us” flyer, sample email content for your listservs, and more are all available at https://targethiv.org/imagine.
HIV Cluster Detection and Response Learning Collaborative: Apply Now
CAI’s Technical Assistance Provider – innovation network (TAP-in), together with the New York State AIDS Institute’s Center for Quality Improvement and Innovation (CQII), is launching an HIV Cluster Detection and Response Learning Collaborative. This Collaborative aims to improve HIV cluster detection and response efforts to reduce the number of new HIV diagnoses and better link people newly diagnosed with HIV to care. Join other EHE jurisdictions funded by HRSA to participate in a 15-month learning collaborative that will build community partnerships, share lessons learned from other jurisdictions, discover the latest evidence-based practices, and provide strategies for updating HIV cluster and detection plans. For more information and to apply.
CSTE 2023 Annual Conference Registration is Now Open!
Registration for the 2023 CSTE Annual Conference in Salt Lake City, Utah is now open! This year’s Annual Conference will take place June 25-29, 2023. An early bird discount is offered for registrations completed by 11:59 pm EDT on Thursday, May 4, 2023. Click HERE to register for the 2023 Annual Conference!
CSTE Technical Assistance Request Form - EHE Jurisdictions
CSTE, in collaboration with CDC, NASTAD, and Tsuro Consulting, is offering virtual technical assistance to support Ending the HIV Epidemic (EHE) Phase 1 jurisdictions. The aim of this offering is to support EHE jurisdictions seeking assistance with implementing EHE plans. TA topics include data analysis, data visualization, statistical modeling, and data mapping.
For technical assistance, please complete the CSTE Technical Assistance Request Form - EHE Jurisdictions. Please reach out to Symone Richardson with any questions.
CSTE Infectious Disease Peer-to-Peer TA Consultancy Form - HIV
The CSTE Infectious Disease Program is pleased to offer coordination of peer-to-peer technical assistance. CSTE's HIV peer-to-peer technical assistance will be conducted virtually at this time. To give or receive peer-to-peer technical assistance, please complete the CSTE Infectious Disease Peer-to-Peer TA Consultancy Form. If you have any questions regarding HIV peer-to-peer technical assistance, please reach out to Symone Richardson at srichardson@cste.org. If you have any questions about completing the consultancy form, please reach out to Akila Simmons at asimmons@cste.org.
NCSD Resource: Expedited Partner Therapy (EPT) Toolkit
EPT is an evidence-based practice that allows health care providers to treat the sexual partners of patients diagnosed with a sexually transmitted infection (STI), preventing reinfection of the patient. Through EPT, patients can take prescriptions or medications home to their sexual partner(s) who may be unable or unwilling to visit a health care provider.
NCSD Resource: Minor Consent for STI Services
Minor consent policies exist in every state and are an important tool for protecting the safety and well-being of adolescents, families, and communities. When state legislative sessions discuss policy proposals rooted in false narratives about adolescent healthcare, it's important to provide fact-based information on the need for and benefit of the ability of minors to consent for STI testing. This fact sheet includes topline messages, stakeholder resources, and important documentation to support policy makers, agencies, and organizations as they work to safeguard the health of the adolescents, families, and communities they serve.
NCSD Resource: Adolescent Health Resource Compendium
This resource compendium is an interactive hub filled with a variety of resources for adolescents, young adults, and anyone who works with them. The included resources cover a number of populations, media types, and key priorities with a focus on resources that promote health equity and center marginalized populations. Resources can be filtered by choosing the desired topic under the dropdown menu for each category. Below is a brief description of the key priorities addressed by the included resources. Please note that many resources fit into more than one category and that the resources link to external sites.
NCSD STD Engage 2023: Coming Back Stronger
Save the Date for the STD Engage 2023 in person in New Orleans, LA! The event will take place on May 16-18, 2023, with pre-conference events on May 15.
EHE Community of Practice (CoP) on NASTAD’s Online Technical Assistance Platform (OnTAP)
NASTAD and NACCHO manage a virtual Community of Practice (CoP) to support peer-to-peer learning and mentorship for EHE jurisdictions. The EHE CoP is housed on NASTAD’s online technical assistance platform (OnTAP) for those leading their jurisdictions' EHE efforts at local and state health departments to share resources and news, discuss challenges and successes, access notes from monthly EHE Office Hours calls, and request technical assistance (TA). If you need access to OnTAP, please contact Krupa Mehta.
Ending the HIV Epidemic Jurisdictional Directory
NASTAD maintains an Ending the HIV Epidemic (EHE) Jurisdictional Directory. Health department staff members are encouraged to update their jurisdiction’s information using this brief form.
Jurisdictional Map of Phase 1 EHE Final Plans
NASTAD released a resource that provides access to Phase 1 EHE websites and plans. Please email Krupa Mehta additional Phase 1 EHE plans for inclusion in this resource, as well as any changes to existing plans.
Job Postings
RFP for Consultants for the EHE Mentorship program
NASTAD is seeking applications from experienced professionals to provide subject matter expertise on End the HIV Epidemic. Consultants with experience facilitating and developing materials for cohort-style shared learning institutes. Also having expertise working with health departments and other public health systems, particularly urban and/or rural ones. The consultants selected will inform the implementation of NASTAD’s EHE Mentoring Program and contribute to technical assistance (TA) to participants in the Mentoring Program at NASTAD.
Manager, Health Systems Integration (Data Integration) – NASTAD
The Manager, as part of the Health Systems Integration team, provides support on population health informatics and data linkage processes, focusing on HIV surveillance data and health care data systems, including Medicaid claims databases. The Manager will support NASTAD’s population health informatics portfolio, supporting robust technical assistance support in the area of data systems integration and serves as a resource to health departments seeking to integrate disparate data sources.
Director, Health Care Access – NASTAD
The Director plays a vital leadership role in achieving the organization’s training, technical assistance, and policy support priorities for Ryan White HIV/AIDS Program (RWHAP) Part B and AIDS Drug Assistance Programs (ADAP). Under the supervision of the Senior Director, Public Health Systems, and in close collaboration with other Public Health Systems leadership, the Director, Health Care Access, will oversee and contribute to Health Care Access program activities related to the national RHWAP Part B ADAP training and technical assistance cooperative agreement with the Health Resources Services and Services Administration (HRSA) HIV/AIDS Bureau (HAB) (HRSA-22-025), provide leadership and expertise to the Ending the HIV Epidemic: A Plan for America – Systems Coordination Provider (HRSA-20-089) portfolio, and support other HIV care and treatment projects in the Public Health Systems portfolio.
Senior Director, Health Equity – NASTAD
The Senior Director is responsible for the strategic leadership, direction, and results of NASTAD’s internal and external health equity, anti-racism, and anti-stigma activities; leading the “Health Equity” priority of NASTAD’s strategic plan. The Senior Director, of Health Equity, is responsible for developing and implementing training and professional development regarding these cross-cutting issues. The Senior Director, Health Equity supervises the work of NASTAD staff on the Health Equity Team. Additionally, the Senior Director, of Health Equity’s role includes leading NASTAD’s member services activities to enhance member engagement. The Senior Director, of Health Equity, frequently interacts with NASTAD members, partners, and federal agencies. The position upholds and advances NASTAD’s values, mission, and priority goals and objectives with an understanding of the organization’s resources and policies, and grant requirements. This position is defined within the Public Health Programs Specialists family.
Senior Manager, Grants Risk Assessment and Compliance – NASTAD
The Senior Manager is responsible for the effective compliance oversight of subrecipient’s compliance with applicable regulations such as 2 CFR 200, 45 CFR Part 75, and the terms and conditions of the award. The position is also responsible for collaborating with Grants and Compliance staff in performing a variety of pre-award assessments and post-award monitoring activities. The position works closely with the Associate Director and the Manager of the Grants and Compliance team, on promoting compliance goals and objectives and enhancing policies, procedures, controls, training, testing, and related practices.
Program Analyst, HIV - NACCHO
We are seeking a motivated person with experience in project management and organization and experience with HIV. An understanding of how local health departments are engaged in efforts to address HIV is also appreciated.
News Bulletin
With an $11 billion price tag, the White House pitches a plan to end hepatitis C
“The Biden administration is calling on Congress to fund a more than $11 billion program to eliminate hepatitis C in the United States. It’s a significant price tag for a single line in the broader budget request; while the $11 billion ask would cover five years of the new initiative, including everything from purchasing pricey drugs that cure the condition to developing new tests to detect the infection, it still dwarfs the annual budget request for the entire Food and Drug Administration, at $7.2 billion. The annual request for the Substance Abuse and Mental Health Services Administration also comes in below the hepatitis C topline, at $10.8 billion.”
Almost Half of All Public Health Workers Left Their Jobs Over the Past 5 Years
“Nearly half of all public health workers in state and local agencies left their positions over the last half-decade, a new study found…Importantly, more than 100,000 workers -- which amounts to half of the total governmental public health workforce -- could leave by 2025 if current trends continue, the group detailed in Health Affairs.”
ICYMI: Research Roundup from CROI 2023
“Last month, HIV.gov had the opportunity to speak with our colleagues from NIH, CDC, and HRSA and with community members about the latest research on HIV and related issues presented at the 2023 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, WA. Here’s a roundup of key topics covered in our blog posts and video conversations so you can catch up on any of that you may have missed and share them with your friends and colleagues.”
Investing in National HIV PrEP Preparedness
“The stage is set for innovative national PrEP access, but to make it happen, Congress and the administration would have to act. The limited funding allocated to the “Ending the HIV Epidemic in the U.S.” initiative in the FY 2023 budget could be a first step toward building a national PrEP program for uninsured and underinsured people, but more action is needed.”
Could Earlier Initiation of HPV Vaccine Boost Immunization in Adolescents?
“Teenagers had better vaccine coverage against human papillomavirus (HPV) if they were vaccinated at earlier ages as older children instead of early adolescents, a retrospective study showed…Moving routine HPV vaccination from ages 11 to 12 years -- the current Advisory Committee on Immunization Practices-recommended age -- to ages 9 to 10 may improve coverage rates in early- and mid-adolescence, "thereby increasing the public health benefit of vaccination," the Merck group suggested.”
Grindr to distribute free home HIV tests
"Grindr, the popular LGBTQ+ dating app, is distributing free at-home HIV tests as part of a new public health initiative. The app explained in a blog post that access to HIV testing is “one of the biggest limitations in the fight against the persistent HIV epidemic.” HIV continues to affect the gay, bi and trans community more than many other groups. The test is now available to order within the app’s main menu to US-based users with a new “Free HIV Home Test” button. People will get an OraQuick kit, an FDA-approved, over-the-counter test that works by swabbing the gums and takes around 20 minutes to see results."