Ending the HIV Epidemic Newsletter
NASTAD, with collaboration from 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 2022 Appropriations
Appropriators are making progress on a federal spending agreement, moving towards resolving a months-long budget impasse before the upcoming funding deadline. On February 8, the House of Representatives approved a continuing resolution (CR) (H.R.6617) that would extend current funding levels through March 11. The new CR would buy appropriators more time to establish a Fiscal Year 2022 (FY2022) appropriations omnibus bill before the current CR expires on February 18.
On February 9, top appropriators announced that bipartisan, bicameral negotiators reached an agreement on an overall spending framework for a FY2022 appropriations omnibus bill. With the topline framework in place, House and Senate appropriations committees will begin to negotiate programmatic funding levels and draft the spending bill text. Should the Senate approve the House-passed CR, lawmakers would have through March 11 to finalize the FY2022 omnibus.
However, Senate Republicans are threatening to block the CR, citing opposition to language in the Biden Administration’s first-ever federal harm reduction grant program around safer smoking kits. On February 9, the White House Office of National Drug Control Policy (ONDCP) Director Rahul Gupta and Department of Health and Human Services (HHS) Secretary Xavier Becerra issued a joint statement rejecting the mischaracterization of the harm reduction program, pointing to the evidence-based success of harm reduction strategies for avoiding overdose and improving the health of drug users. However, Republicans are increasingly calling for a CR and eventual FY2022 package that are clear of ‘controversial’ policy riders, such as the removal of the prohibition on the use of federal funds to purchase syringes and sterile injection equipment, despite bipartisan support for the language.
NASTAD will continue to monitor the FY2022 appropriations process to advocate for the highest funding levels on behalf of HIV and hepatitis programs.
NASTAD Calls on Biden-Harris Administration to Create National PrEP Grant Program
On February 7, NASTAD joined a coalition of over 110 organizations and called on the Biden-Harris administration to support the creation of a national PrEP grant program to prevent HIV in the U.S. In order to increase PrEP uptake among communities most impacted by HIV, the advocates request the creation a fully-funded federal program that builds upon the PrEP expansion goals laid out in the EHE initiative. The coalition requests $400 million in FY2023 to provide grants to community-based organizations and state and local health departments to implement the program, which would increase patient and provider PrEP education, fund ancillary PrEP services, and provide PrEP to uninsured individuals.
Administration Activities
NASTAD Joins ONAP Listening Session on HIV Criminalization
On January 25, NASTAD joined a virtual listening session hosted by the White House Office of National AIDS Policy (ONAP) on HIV criminalization laws. ONAP convened a table of legal, academic, and public health experts, including people living with HIV, who shared their thoughts on ways to eliminate or reform outdated HIV criminalization laws. Combatting HIV stigma and criminalization is a key component of the National HIV/AIDS Strategy (NHAS), which calls for repeal and reform of state HIV criminalization laws as a strategy to reduce HIV-related stigma and discrimination and the complex barriers they pose for people with or who experience risk for HIV.
NHAS Federal Implementation Plan
In January, ONAP convened the NHAS Federal Implementation Workgroup (NHAS FIW) to launch the process to begin development of the NHAS Federal Implementation Plan (NHAS FIP). The departments and agencies involved in contributing to the NHAS FIP have started developing action steps for the 21 objectives and 78 strategies included in NHAS. The agencies were asked to explore cross-agency, collaborative actions to maximize impact and resources moving forward. Federal agencies were also encouraged to consider ideas from their community partners and other stakeholders as they develop their action steps.
ONAP also recently convened a NHAS FIW subgroup co-chaired by CDC and HRSA to begin work on creating the developmental indicator on quality of life for people with HIV. The NHAS called for this, noting, “quality of life for people with HIV was designed as the subject for a developmental indicator, meaning that data sources, measures, and targets will be identified, and progress monitored thereafter.”
NASTAD will submit comments and recommendations highlighting health departments’ key role in ensuring the Strategy’s mission and vision become realities.
PACHA Virtual Meeting
The Presidential Advisory Council on HIV/AIDS (PACHA) is convening its 73rd meeting on Monday, March 14 and Tuesday, March 15 from 10:30 AM – 4:30 PM ET on both days. The meeting agenda will be posted on the PACHA page on HIV.gov prior to the meeting. The meeting will be virtual and interested stakeholders can view the meeting via livestream at www.hhs.gov/live. Agenda topics during the two-day PACHA meeting include: Strengthening the HIV Workforce; Women and Girls: Why Representation Matters; Providing PrEP for the Nation; and PEPFAR Guidance to Countries for 2022.
PACHA has dedicated time during their next meeting for a virtual “PACHA-to-the-People” community engagement session. Community members will be able to virtually join the discussion and provide the Council with feedback on two broad topics: (1) HIV Prevention in the Context of Ending the HIV Epidemic and (2) the National HIV/AIDS Strategy (NHAS) and the Ending the HIV Epidemic (EHE) initiative. Each breakout room will be co-facilitated by PACHA members, and participants can attend either session, or both of them. The “PACHA-to-the-People” virtual community engagement session will take place on Monday, March 14, 2022, from 12:30 PM – 2:45 PM ET.
NASTAD Comments on NIH Strategic Plan for HBV Research
On January 31, NASTAD signed onto comments submitted by the Hepatitis B Foundation and Hep B United on the National Institutes of Health (NIH) Strategic Plan for Trans-NIH Research to Cure Hepatitis B. The strategic plan, originally published in 2019, details three strategic priorities for boosting the agency’s capacity to conduct innovative research in search of a cure for hepatitis B (HBV). The updated plan will also align with the cross-divisional HHS Viral Hepatitis National Strategic Plan.
National Black HIV/AIDS Awareness Day (NBHAAD)
National Black HIV/AIDS Awareness Day (NBHAAD), observed on February 7, is a day to spark conversations and address the impact of HIV on Black communities. As part of the HHS EHE initiative, CDC is working with health departments and community-based organizations to promote HIV testing, prevention, and treatment and reduce HIV stigma in Black communities. On February 4, CDC released reports detailing the prevalent disparities in HIV care by race.
- Dear Colleague Letter: National Black HIV/AIDS Awareness Day
- Fact Sheet: HIV and Black/African American People in the U.S.
- MMWR: Association Between Social Vulnerability and Rates of HIV Diagnoses Among Black Adults, by Selected Characteristics and Region of Residence — United States, 2018
- MMWR: Notes from the Field: COVID-19 Vaccination Among Persons Living with Diagnosed HIV Infection — New York, October 2021
Resources
Systems Coordination Provider Project
NASTAD Systems Coordination Provider (SCP) staff continues to participate in HRSA Ending the HIV Epidemic Programmatic Site Reviews through February 2022. Site reviews were not held in January 2022. The site reviews serve as an opportunity for the SCP and CAI, the Technical Assistance Provider (TAP), to provide an overview of the SCP and TAP-in projects and hear directly from jurisdictions about their EHE program and activities, and identify TA requests.
NASTAD SCP NASTAD’s newly launched EHE mentoring program is a three-to-six-month intensive strategy to assist newly hired EHE Managers, Coordinators, and other EHE staff at health departments in EHE Phase I jurisdictions. The program will focus on developing leaders, identifying emerging talent, and streamlining processes to improve systems operations and ensure data-driven service outcomes. Twenty-six mentees are currently engaged in the EHE mentorship program representing seventeen jurisdictions. For additional information, please contact Darion Banister.
NASTAD Resource: Navigating the Harm Reduction Funding Landscape: A Guide for State, Federal, and Private Funding
This guidance document was designed to assist a variety of harm reduction programs — ranging from small-scale grassroots organizations to larger harm reduction programs — with navigating the funding landscape and fulfilling the requirements laid out in grant proposals and their application process.
NASTAD Resource: Diversifying PrEP Financing: Strategies to Leverage Funding across the PrEP Care Continuum
Recent changes to the PrEP medication landscape have impacted the way that 340B covered entities are able to generate program income from PrEP medications. These changes have led to declining revenues resulting in the potential destabilization of program and client support systems aimed at increasing PrEP access.
This tool provides an overview of these landscape changes, discusses the impacts of these changes, and explores opportunities to meet the funding needs of PrEP ancillary services.
To continue the conversation on leveraging different funding strategies, join NASTAD for a webinar on Wednesday, March 9, 2:00 – 3:00 PM ET. Register for the webinar here.
For questions about this resource, contact NASTAD’s PrEP team.
NASTAD is Hiring: Manager, Prevention (PrEP, Partner Services, Self-testing)
NASTAD is hiring a Manager, Prevention to support and implement current and new PrEP, partner services, and self-testing activities. Please share with your networks.
To learn more about the position or apply, follow this link. For any questions, reach out to Kristina Santana.
Social Determinants of Health (SDH) Monthly Highlight
NASTAD is conducting an ongoing monthly series that highlights the intersection of HIV prevention and care with a specific social determinant of health (SDH). February’s topic is Employment Challenges. You can look forward to more information about this being released later this month.
Flashback: In October 2021, NASTAD and the National Network to End Domestic Violence (NNEDV) hosted a webinar, Positively Safe: Addressing the Intersection of HIV and Domestic Violence. The recording and slides can be viewed here.
NASTAD Status-Neutral Webinar Series
NASTAD is hosting a four-part webinar series, “Employing Status-Neutral Approaches to End the HIV Epidemic”. The series will focus on status-neutral approaches for CDC and HRSA funded health departments working to end the HIV epidemic.
The first webinar in the series, “Status-Neutral Approaches 101” was held on December 14. The recording and slides can be viewed here.
The second webinar in the series, “Trauma-Informed Approaches to HIV Services” was held on January 14. The recording and slides can be viewed here.
The third webinar in the series, “Addressing Social Determinants of Health through a Status-Neutral Lens” was held on Tuesday, February 8, 2022, from 2:00 – 3:30 PM ET. The recording and slides will be made available on NASTAD’s website within the next week.
Registration: The final webinar in the series, “Status-Neutral Messaging and Promotion for EHE” will be held on Tuesday, March 8, 2022, from 2:00 – 3:30 PM ET. You can register for the webinar here.
AIDS United NOFO: iFORWARD: Equipping Organizations in the South through Technology to End the HIV Epidemic
Applications Due: February 17, 2022
AIDS United has launched iFORWARD: Equipping Organizations in the South through Technology to End the HIV Epidemic, a special project designed to address barriers southern organizations face in accessing appropriate technology to carry out their services and achieve their mission. iFORWARD will provide cash grants up to $10,000 along with professional development and technical assistance.
CAI Webinar: Beyond the Walls: Building Bridges for Post-Release Linkages to Care & Community
Date & Time: Thursday, February 24th, 2022, 1:00 – 2:00 PM EST
This webinar will highlight effective models and best practices for connection to care for justice-involved PWH and describe how jurisdictions can overcome common barriers when managing a jail linkage program. The partnerships between jurisdiction's EHE teams and jail systems in Maricopa County (AZ) Jail System and the Orlando County (FL) exemplify the importance of implementation of evidence-informed interventions on both sides of "the walls" to achieve the goals of the EHE initiative. Register for the webinar here.
Lancet Article: Estimating naloxone need in the USA across fentanyl, heroin, and prescription opioid epidemics: a modelling study
“Opioid epidemic type and how naloxone is accessed have large effects on the number of naloxone kits that need to be distributed, the probability of naloxone use, and the number of deaths due to overdose averted. The extent of naloxone distribution, especially through community-based programmes and pharmacy-initiated access points, warrants substantial expansion in nearly every US state.”
NACCHO is accepting applications for a Strategic Communications and Marketing Consultant for the National Harm Reduction Technical Assistance Center. NACCHO will award up to $150,000 to a consultant to develop and support the implementation of a marketing and communications plan for the NHRTAC. The consultant will work with NACCHO and NHRTAC stakeholders to develop communications and marketing goals for the NHRTAC, design and establish an identity for the NHRTAC, identify target audiences, develop messaging and media for demand creation, and support implementation of marketing and communication activities identified in the plan. The deadline for submission is Monday February 28, 2022 by 5:00 PM ET. Decisions will be made, and applicants will be notified of their selection status, no later than Friday, March 11, 2022. Applications should be submitted, in pdf, via e-mail to Lucy Slater (lslater@naccho.org). View the request for proposal here: https://bit.ly/3omA1VG
NACCHO is Seeking an RWHAP Rapid ART Policy and Decision Makers Playbook Consultant(s)
NACCHO is accepting applications for a consultant(s) to create materials to support the development of the Rapid ART Policy and Decisions Makers Playbook and supporting tools. NACCHO will provide a framework/draft outline of the Playbook, including desired content. The consultant will work with NACCHO to determine and develop the most effective media to present the content. The consultant should be an expert in content creation, design, layout, and publication. NACCHO will award up to $15,000 for this role. Submissions must be electronic, in pdf format. The deadline for submission is 5 pm, Eastern Standard Time, Monday, February 28th, 2022. Decisions will be made, and applicants will be notified of their selection status no later than Friday, March 11th, 2022. Applications should be submitted, in pdf, via e-mail to Sabrina Gandy (sgandy@naccho.org). View the request for proposal here: https://bit.ly/3osiCuy
NACCHO Releases an STD Registry – Guide to Sexually Transmitted Disease Clinics in the United States
NACCHO has developed an STD Registry, a searchable tool for locating STD clinics and services. We encourage any clinic devoted to examining and treating STDS and/or clinics that have staff and service hours dedicated to STDs to register. Please use the following submission form to add your site to the registry.
Now Available: NACCHO and NCSD Webinar on the 340B Drug Pricing Program
On January 25, 2022, NACCHO and National Coalition of STD Directors (NCSD), hosted a webinar exploring 340B Drug Pricing Program. Watch the webinar to learn how the 340B Drug Pricing Program can support health department operations such as saving money, generating revenue, and expanding sexual health services. You can access the slides, recording, and transcript on the HSH homepage. Please feel free to pass these along to colleagues who may be interested!
What is the State of LGBTQ Health? Take the Inaugural Survey!
The National Coalition for LGBTQ Health's Inaugural State of LGBTQ Health National Survey™ assesses the healthcare landscape for LGBTQ patient populations. This survey covers intersectional topics in LGBTQ health including clinical/behavioral health, stigma, social justice, housing/homelessness, health disparities among communities of color, and COVID-19. The insights provided by completing this brief yet comprehensive survey will help inform ongoing advocacy, education, research, and training activities that support LGBTQ health care. Input also will help determine the theme for the Coalition's 20th Annual National LGBTQ Health Awareness Week to be held March 21-25, 2022.
2022 Model and Innovative Practice Award Applications Now Open
NACCHO’s annual award cycle for local health departments is now open, and local HIV programs are encouraged to use this opportunity to share about your ongoing Ending the HIV Epidemic work. In particular, the Innovative Practice Awards recognize adaptations and innovations created in response to the COVID-19 pandemic and related challenges such as changes in staffing structures and outreach practices. These awards are vital to highlighting and sharing promising practices at the local level. Please consider this opportunity to showcase your teams’ hard work and/or share this opportunity with your local health department partners! For questions, contact model-practices@naccho.org and CC ehe@naccho.org.
NACCHO HIV, STI, and Viral Hepatitis Team is Hiring
Director, HIV and Harm Reduction
NACCHO is excited to recruit for a director to oversee HIV and Harm Reduction projects within the HIV, STI, Viral Hepatitis portfolio. The director will lead a fantastic team and projects aimed to strengthen the capacity of local health departments and their partners by providing learning opportunities, developing tools and resources, and providing technical support. An ideal candidate will have familiarity with national HIV programs, funders and partners, experience working with HIV programs or harm reduction programs at the local level, and experience managing a diverse portfolio of projects.
CSTE Annual Conference Registration is Open
Early bird registration for the 2022 CSTE Annual Conference June 19-23rd in Louisville, KY is now open and will close on May 5th. The Annual Conference is currently hybrid with virtual and in-person sessions. For the most up-to-date information, please visit the conference website.
JSI Integrated HIV/AIDS Planning Technical Assistance Center (IHAP TAC) Webinar and Peer Learning Series
As the national technical assistance provider for integrated planning, JSI’s IHAP TAC continues to host monthly webinars and peer learning sessions to guide state and local jurisdictions as they work on their Integrated HIV Prevention and Care Plans for CY 2022-2026. For more information, please visit the IHAP TAC website here.
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.
News Bulletin
Racial Health Disparities in HIV Fueled by SDOH, Social Vulnerability
“Black people still make up a disproportionate share of individuals diagnosed with HIV, with the latest CDC Morbidity and Mortality Weekly Report (MMWR) revealing that those new diagnoses are among the most socially vulnerable, underscoring the link between social determinants of health and health disparities.”
Pandemic Era Tests May Speed Hepatitis C Detection
“Automated molecular tests could compress this process. From a small sample of blood or saliva, the tests amplify any trace of viral genetic material in a process akin to the older laboratory-based method of polymerase chain reaction (or PCR), but have been miniaturized to run on small machines. The technologies have been around for years but gained greater visibility during the pandemic, when the FDA allowed many test developers to leapfrog what is traditionally a lengthy approval process... A similar molecular test for hepatitis C could allow clinicians to deliver a diagnosis immediately and perhaps start many patients on medications the same day, an approach known as “test and treat.” Patients may then be less likely to transmit the disease to others, and more likely to complete treatment and be cured.”
How Supervised Drug Consumption Sites Could Help Solve The Opioid Crisis
“…New York City opened the United States' first overdose prevention centers. They're sites where people can safely use drugs under the supervision of people trained to spot and reverse overdoses. These centers are part of a broader strategy of harm reduction, a set of strategies designed to minimize the negative effects of drug use. While the harm reduction model has been embraced by the Biden Administration, they haven't endorsed supervised consumption sites. But is this something the Biden Administration is watching as a possible approach to help reduce the growing number of overdose deaths? "Absolutely," Dr. Rahul Gupta, director of the White House Office of National Drug Control Policy, told 1A.”
HIV PrEP Access May Be Limited by States’ Prescriber Laws
“A recent study, published in the Journal of the Association of Nurses in AIDS Care (JANAC), found that stricter state laws that require medical doctors (MDs) to decide NP and PA autonomy may hinder the number of patients using HIV pre-exposure prophylaxis (PrEP).”