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. NASTAD maintains 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
FY2025 Appropriations
Appropriators are weighing their options to advance a Fiscal Year 2025 (FY2025) funding measure by the December 20 deadline afforded by the current continuing resolution (CR) (H.R.9747). Congress returned from recess on November 12, resuming efforts to advance must-pass legislation during the lame duck session, including the FY2025 spending bills. In September, House Appropriations Chair Tom Cole (R-OK-04) called on Republicans to advance the FY2025 spending bills before the new year, but Republicans may now try to pass another CR that extends past the start of the 119th Congress in January 2025 to leverage their new Congressional majority.
NASTAD will continue to monitor the congressional appropriations process and advocate for the highest possible funding for HIV, hepatitis, and drug user health programs.
119th Congress
Lawmakers are preparing the transition to the 119th Congress, which begins on January 3, 2025. House Republicans voted to maintain current leadership for the new Congress, including Rep. Mike Johnson (R-LA-04) as Speaker of the House and Rep. Steve Scalise (R-LA-01) as Majority Leader. After reclaiming the Senate majority, Republicans voted to approve Senator Mike Thune (R-SD) as the upper chamber’s Majority Leader on November 13, who will succeed Senator Mitch McConnell (R-KY). House Democrats meet on November 19 and voted to main current leadership with Rep. Hakeem Jefferies (D-NY-8) as Minority Leader and Rep. Katherine Clark (D-MA-5) as Democratic Whip. Senate Democrats have not scheduled leadership elections, but current Majority Leader Chuck Schumer (D-NY) is expected to retain the party leadership role as Minority Leader.
Administration Activities
Presidential Transition
On November 14, President-elect Trump announced his nomination of Robert F. Kennedy, Jr. (RFK) to lead the Department of Health and Human Services (HHS). RFK, a former presidential candidate in the 2024 election, is known for his anti-vaccine advocacy and championed ending the “chronic disease epidemic” during his campaign. Trump has also announced additional key health nominations that will also require Senate confirmation: former Florida Rep. Dave Weldon to lead the Centers for Disease Control and Prevention (CDC), Dr. Janette Nesheiwat to be surgeon general, surgeon Marty Makary to lead the Food and Drug Administration (FDA), and Dr. Mehmet Oz to be the Centers for Medicare and Medicaid Services (CMS) administrator.
HHS Releases STI Progress Report
On November 7, the Department of Health and Human Services (HHS) released the 2021-2023 Progress Report for the Sexually Transmitted Infections National Strategic Plan for the United States: 2021–2025. The progress report shows mixed results to achieve core epidemiologic indicators for chlamydia, gonorrhea, syphilis, and human papillomavirus. Notably, the report showed persistent challenges to reduce overall rates of primary, secondary, and congenital syphilis, but improvements in reducing rates of gonorrhea. Additionally, the report includes the Herpes Simplex Virus (HSV) Addendum to STI National Strategic Plan, which sets a unified national response to HSV, a condition that was not originally included in the STI National Strategic Plan.
FDA Warns Public Health Programs that DBS Self-Collection Kits for HIV have not Been Authorized for Marketing and Use
On October 29, the Food and Drug Administration (FDA) released a notice advising public health programs administering HIV testing that HIV blood sample self-collection kits are being marketed in the United States without the required FDA marketing authorization. Currently, FDA has not authorized any self-collection kits to collect blood samples, including dried blood spot self-collection cards, for HIV testing. This notice greatly impacts telePrEP programs utilizing DBS technology for HIV screenings as part of PrEP initiation and continuation labs. Starting on Friday, November 1, 2024, the TakeMeHome program will remove HIV DBS testing from their testing options in accordance with the FDA warning letter. Other telePrEP programs utilizing this testing technology may be following suit in compliance with the FDA notice. Currently, OraQuick In-Home HIV Test is the only HIV self-test with FDA authorization. TelePrEP programs have developed successful models that don’t depend on DBS self-collection kits through partnerships with commercial and public health laboratories. NASTAD will continue to provide updates as more develops and continue to share best practices related to the tests recommended for PrEP care.
HHS Finalizes Regulation that will Expand HBV Vaccine Access through Medicare
On November 1, the Department of Health and Human Services (HHS) Centers for Medicare and Medicaid Services (CMS) issued a final rule that will expand access to hepatitis B (HBV) preventive vaccines through Medicare Part B. Starting January 1, 2025, a physician’s order will no longer be required to administer an HBV vaccine under Medicare Part B, which will facilitate increased utilization of HBV vaccines through the mass immunizer program. Additionally, CMS expanded its coverage eligibility to include anyone who has not completed an HBV vaccination series and increased the affordability of vaccine administration at Rural Health Clinics and Federally Qualified Health Centers (FQHCs). Together, these reforms will contribute to HBV prevention and viral elimination by removing barriers to vaccination in the Medicare program, increasing access points for vaccination, and facilitating greater consumer coverage and affordability for vaccinations.
IHS Awards $12.3 million to help fight HIV, HCV, and Syphilis
On October 29, the Indian Health Service (IHS) announced that it awarded $21.3 million to fight HIV, hepatitis C, and syphilis in Native communities. The funding will be administered by 17 tribal and urban Indian organizations as part of the Ending the HIV/HCV/Syphilis Epidemics in Indian Country (ETHIC) initiative. The funding will support day-to-day delivery of services and equitable access to care to improve health outcomes and reduce disparities among Native populations.
CDC Awards $4.8 Million to Support Doxy PEP Implementation and HIV/Syphilis Point-of-Care Testing
On October 25, the Centers for Disease Control and Prevention (CDC) announced that it awarded $4.8 million to support the implementation of doxycycline as post-exposure prophylaxis (doxy PEP) and HIV and syphilis point-of-care testing. The funding, provided by the Department of Health and Human Services (HHS) Minority HIV/AIDS Fund, will be used to design and test strategies to assure doxy PEP coverage for gay, bisexual, and other men who have sex with men and transgender women, and study the impact and feasibility of syphilis/HIV point-of-care testing among cisgender women of reproductive age. Project activities will target key jurisdictions that were prioritized by the National Syphilis and Congenital Syphilis Syndemic (NSCSS) Federal Task Force and the Ending the HIV Epidemic in the U.S. (EHE) initiative.
HHS, White House Request Public Comment to Inform Development of New HIV, Hepatitis Strategic Plans
The Biden-Harris Administration is currently developing the 2026-2030 national strategic plans for HIV, viral hepatitis, STIs, and vaccines. HHS Office of Infectious Disease and HIV/AIDS Policy (OIDP) and White House Office of National HIV/AIDS Policy (ONAP) produce these quinquennial strategic plans to coordinate a whole-of-society response to the epidemics while setting epidemiological, programmatic, and policy goals that federal agencies and partners will work to achieve over the next five years. Through December 6, 2024, OIDP and ONAP are requesting public comment to inform the development of these plans. NASTAD is drafting a comment submission to uplift the priorities and policy recommendations that will facilitate the work of our members and bring the country closer to ending the epidemics. Please consider sharing any information and comments with us that you would like to see included in NASTAD’s submission via this Google Form by November 25.
Resources
Rapid ART Implementation in an Emergency Department to End the HIV Epidemic CAI TAP-in Case Study: Tarrant County, TX
We are excited to announce that a case study highlighting CAI’s TAP-in technical assistance is now available: Rapid ART Implementation in an Emergency Department to End the HIV Epidemic. Emergency departments (EDs) can play a key role in providing access to HIV care in disproportionately affected populations. This case study explores Rapid ART implementation in an emergency department in Fort Worth, Tarrant County, Texas, and how technical assistance supported every phase of the program, which can serve as a model for other EHE jurisdictions. Patients receive their HIV medication immediately upon diagnosis in the ED. Before this pilot, the average time from HIV diagnosis to viral suppression was seven months. With the initiation of Rapid ART in the ED, people with HIV are now achieving viral suppression within 27 days of their diagnosis!
To learn more about TAP-in's work, visit our page at TargetHIV. To request TA from TAP-in to support your HRSA EHE program or be added to the listserv to receive more information on future programming, please contact tap-in@caiglobal.org.
HHS Resource: Guidance for Non-HIV-Specialized Providers Caring for Persons With HIV Who Have Been Displaced by Disasters
“This guide from the U.S. Department of Health and Human Services provides guidance to health care providers attending to the medical needs of adults, adolescents, and children with HIV who have been affected by disasters or displaced from disaster areas and who have not yet secured HIV care in the areas where they have relocated.”
EHE Success Stories and Innovations
As part of our ongoing commitment to foster collaboration and share best practices in public health, NASTAD is excited to announce an opportunity for jurisdictions to showcase their innovative initiatives on our microsite dedicated to public health advancements. NASTAD will be releasing a series of success stories highlighting EHE innovations across both CDC and HRSA funding streams that address the four pillars: diagnose, treat, prevent, and respond.
By sharing your innovations, you not only have the opportunity to showcase your jurisdiction's achievements but also to contribute to a global knowledge-sharing platform that can benefit public health practitioners, policymakers, researchers, and communities worldwide.
Please find the survey link attached HERE. Please reach out if you have any questions or need assistance completing the survey. Please contact EHESCP@nastad.org with any questions.
University of Pennsylvania Survey: PrEP Use Across EHE Jurisdictions
The Social Action Lab at the University of Pennsylvania is inviting health departments across the EHE jurisdictions to participate in a research study. The purpose of the study is to explore strategies to improve PrEP use across EHE jurisdictions. Through a survey link, the research team is looking to collect data on structural determinants of PrEP use and policy implementation factors in your EHE state/county. Participants will be invited to a PrEP promotion conference fully sponsored by the team at the University of Pennsylvania and to participate in research publications resulting from the project.
If you are interested in participating, please contact Bita Fayaz Farkhad at bitaf@upenn.edu to learn more and to receive the link to the survey. We hope you will consider participating.
Please contact Natalie Cramer or Kristina Santana with questions.
NASTAD and RAISE Webinar Series
The Research Alliance in Implementation Science to End HIV (RAISE) Hub aims to advance the implementation of EHE initiatives through evidence-based interventions. NASTAD is proud to collaborate with The University of Washington/Fred Hutch Center for AIDS Research on the RAISE Hub on this initiative which includes a monthly webinar series. To learn more about RAISE and view previous webinars, click here.
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.
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. NASTAD has recently updated the EHE Jurisdictional Directory, which lists local and state points of contact for all EHE Phase 1 jurisdictional activities. This directory is used to communicate with EHE Phase 1 jurisdictions, disseminate resources, and gather information. 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
Director of the Ryan White Office of Support—Harris County, TX
The Director serves as the liaison between the County Judge and the Houston EMA Ryan White Planning Council (RWPC), providing support to the Council and direct supervision to its staff as they fulfill their legislatively mandated responsibilities within the Ryan White Part A Program. The Director also works closely with Harris County Public Health/Ryan White Grant Administration (the Grant Administrator), other elected and appointed officials, service providers, community leaders, Persons Living with HIV (PLWH), and others within the six-county service area. Apply by December 9, 2024.
News Bulletin
Trump on RFK’s role in banning vaccines in his administration: ‘I’ll make a decision’ “Former President Trump said he would “make a decision” regarding banning certain vaccines if he wins the White House on Tuesday and former independent presidential candidate Robert F. Kennedy is a part of his administration. In an interview with NBC’s Dasha Burns on Sunday, Trump didn’t rule out the possibility of banning a vaccine, though he also provided no specifics in discussing Kennedy’s potential role on health policy matters in his administration.”
The Overdose Crisis Was Ignored in This Election Cycle
“The overdose crisis claims over 100,000 lives each year in the United States, but has received very little attention from leading candidates Kamala Harris (D) and Donald Trump (R) during the presidential election campaign. Whatever the outcome after November 5, the winner will face a continuing public health emergency. Proven lifesaving strategies are available. But to different degrees, the candidates’ sparse words on the topic have focused on continuing the drug war that led us here.”
35 Health Advocacy Groups Urge the Supreme Court to Protect Preventive Care
“35 organizations, representing millions of patients with serious health conditions and thousands of health care professionals, filed an amicus curiae, or “friend-of-the-court,” brief in the case of Braidwood v. Becerra at the U.S. Supreme Court. The amicus brief supports the government’s petition for certiorari in the case, providing extensive scientific data demonstrating that preventive services save lives and are cost-effective. At the crux of the case is a provision of the Affordable Care Act (ACA) that requires most insurers cover preventive services recommended by the United States Preventive Services Task Force (USPSTF) without cost-sharing by patients.”
$4.7M Grant to Combat Smoking and HIV in Black Adults
“Can a mobile health app help Black adults living with HIV quit smoking and manage their stress? Scientists from the University of Houston (UH) Health Research Institute are using a $4.7 million grant to test just such an app, according to a UH news release. The National Institute on Minority Health and Health Disparities grant will support a randomized control trial with more than 300 Black smokers with HIV to test the benefits of a mobile health app developed to help users quit smoking and better manage their stress and chronic diseases.”