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
House Resumes Appropriations Bill Markups
Lawmakers are increasingly focused on advancing fiscal year 2024 (FY2024) spending bills following the passage of the bipartisan Fiscal Responsibility Act of 2023 (H.R. 3746) on June 3, which averted an economically devastating default on the nation’s debt. The Fiscal Responsibility Act introduced spending caps for FY2024 and fiscal year 2025 (FY2025), which are complicating spending discussions for both parties: Republicans are seeking to circumvent the caps to boost defense funding, and Democrats are strategizing to avoid the inclusion of damaging programmatic cuts to a range of safety-net programs, including federal health programs. Although Congress has some time to draft and approve the spending bills by the start of FY2024 on October 1, lawmakers are feeling pressure to advance the spending bills promptly, given that the debt limit fix would impose a 1% funding cut for FY2024 if Congress does not pass a spending bill by the start of the new fiscal year.
With a renewed focus on appropriations, House Republicans announced that they would resume postponed markups for several spending bills in June and advance the FY2024 appropriations package by the end of the summer. Additionally, Senate appropriators announced their commitment to advancing spending bills along a similar timeframe. NASTAD will continue to monitor the congressional appropriations process and advocate for the highest possible funding for HIV, hepatitis, and drug user health programs.
Administration Activities
CDC Launches Nonfatal Overdose Data Dashboards
On June 2, the Centers for Disease Control and Prevention (CDC) launched two new data dashboards that expand monitoring of nonfatal overdose trends in the US. The new Drug Overdose Surveillance and Epidemiology (DOSE) dashboard is an interactive data visualization tool that displays current nonfatal drug overdose-related emergency department. and hospital discharge data. CDC’s new Fentalog Study Toxicology Testing Dashboard provides data on the amount of fentanyl, fentalogs, and other substance combinations present in blood samples from people hospitalized with a suspected opioid-involved overdose across 10 study sites. These dashboards will support public health providers and policymakers as they take steps to curb overdose deaths and prevent adverse health outcomes related to nonfatal overdoses.
HHS Releases First-Ever STI Plan
On June 8, the Department of Health and Human Services (HHS) released the first-ever STI Federal Implementation Plan, which details the roles and responsibilities that federal agencies will take to implement the STI National Strategic Plan 2021-2025. The implementation plan highlights over 200 actions that federal stakeholders will take to achieve the strategic plan’s goals of preventing new STIs, reducing adverse outcomes of STIs, accelerating STI research, technology, and innovation, reducing health disparities, and integrating efforts to address the STI epidemic. Advocates applauded the release of the plan, but highlighted the significant challenges that must be addressed to achieve the goals of the plan, including rapidly intervening on the current record-high levels of STIs and beating appropriators’ reluctance to invest significant funding for the CDC Division of STD prevention and HHS Office of Infectious Disease Policy to fully implement the plan.
Increase in People with HIV among Meningococcal Disease Cases in 2022
New CDC surveillance data show an increase in the percentage of people with HIV among meningococcal disease cases in 2022. These findings highlight the importance of healthcare providers
- Ensuring people with HIV are up to date with their MenACWY vaccination, including booster doses
- Maintaining high suspicion for meningococcal disease when someone with HIV presents with symptoms compatible with this disease
- Screening patients with meningococcal disease for HIV
Meningococcal disease is uncommon but deadly. In 2022, nearly 1 in 10 cases of meningococcal disease occurred in people with HIV. Yet vaccine uptake remains low for this population. According to administrative claims data, less than 1 in 6 people with HIV received at least one dose of MenACWY vaccine within two years following their diagnosis.
People with HIV are recommended a two-dose primary series of MenACWY vaccine followed by a booster dose every 5 years. Children with HIV who receive the primary series when they are younger than 7 years old should get their first booster 3 years later, then continue with the regular 5-year booster interval. CDC also recommends that all people be screened for HIV at least once in their lifetime; providers should ensure that patients with meningococcal disease and unknown HIV status are screened for HIV.
President Biden Picks Mandy Cohen to Lead CDC
President Biden announced that Mandy Cohen will be the new lead of the CDC. Cohen will replace outgoing Director Rochelle Walensky, whose tenure will be marked for her leadership during the COVID-19 pandemic and transitioning the country out of the public health emergency. Cohen, a physician by training, served as the chief operating officer and chief of staff at the Centers for Medicare and Medicaid Services (CMS) during the Obama Administration, and later as the Secretary of the North Carolina Department of Health and Human Services from 2017-2021. Senate confirmation is not required to appoint the CDC Director, although the fiscal year 2023 spending package instituted a policy requiring Senate confirmation for incoming CDC Directors starting January 2025. Cohen is expected to step into the role at the end of June immediately following Director Walensky’s departure.
National HIV Testing Day 2023
CDC observes National HIV Testing Day (NHTD) each year on June 27 to highlight the importance of HIV testing. This year’s NHTD theme is “Take the Test & Take the Next Step,” which emphasizes that knowing your HIV status helps you choose options to stay healthy. Regardless of your result, testing is an important starting point to making healthy decisions to protect yourself from HIV and STIs, such as initiating antiretroviral therapy if you are positive, or starting or continuing to use HIV and STI prevention tools like PrEP for HIV, condoms, and vaccines for other sexually transmitted diseases.
Resources
NNDITC Disease Intervention Training
The National Network of Disease Intervention Training Centers (NNDITC) are offering free interactive, skill-building trainings for the disease intervention community! Learn more & register for upcoming courses here.
TAP-in’s Social Media Evaluation Toolkit is Now Available on TargetHIV
Social Media Evaluation: Guidance for EHE Jurisdictions, developed by CAI’s Technical Assistance Provider-innovation network (TAP-in), provides guidance and best practices on the evaluation of social media/media (SMM) campaigns. This information was gathered through our partnerships with EHE jurisdictions that are implementing these campaigns. The information is meant to serve as a starting point for EHE jurisdictions to help you decide how best to measure the success of your SMM campaigns. The toolkit includes concrete examples of data metrics that you can expect to receive from your campaign and recommended best practices for how to use and supplement that data to evaluate your campaign’s success. To request TA from TAP-in on this topic or others to support your HRSA EHE program, please contact tap-in@caiglobal.org.
TAP-in’s Long-Acting Injectables Playbook is Now Available on TargetHIV
Long-Acting Injectables for HIV Antiretroviral Therapy: The Next Revolution in HIV Treatment, developed by CAI’s Technical Assistance Provider-innovation network (TAP-in), is intended to help EHE jurisdictions consider what they can do to enhance the implementation of long-acting injectables (LAI) for ART. This playbook presents best-of-available resources, along with insights from early adopters. Jurisdictions can use this information to work with communities and clinics to gear up their LAI programs. To request TA from TAP-in on this topic or others to support your HRSA EHE program, please contact tap-in@caiglobal.org.
NASTAD Webinars: Syphilis and Drug User Health Webinar Series
The NASTAD Drug User Health Team is pleased to announce an upcoming webinar series exploring syphilis among communities of people who use drugs, in partnership with AIDS United, NACCHO, NCSD, and the Northwest Portland Area Indian Health Board. This webinar series consists of five monthly sessions where those working on STIs – specifically syphilis – and those working in harm reduction and drug user health will be brought together to learn from each other, share promising practices, and highlight effective cross-sector partnerships. To join the webinars please register for them here:
- State Health Department Innovations at the Intersection of Syphilis & Drug User Health – Tuesday, June 27, from 3-4:30pm ET
- “Solo Makes You Go Slow”: Local Partnerships Addressing Syphilis Among People Who Use Drugs – Tuesday, July 25, from 3-4:30pm ET
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.
2023 CSTE Annual Conference Registration
The 2023 CSTE Annual Conference will be held June 25-29th in Salt Lake City, UT. The updated preliminary conference agenda is now available. There is no registration deadline for the 2023 Annual Conference, and on-site registration will be available. For the most up-to-date information, please visit the conference website.
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.
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
Manager, Health Systems Integration
This NASTAD team member plays a vital role in expanding the organization’s Health Systems Integration objectives, including providing technical assistance and systems coordination support to Ryan White HIV/AIDS Program (RHWAP) Part A and B recipients as part of the Ending the HIV Epidemic: A Plan for America (EHE) initiative. Under supervision from the Associate Director and in close collaboration with the Director, Health Systems Integration, the Manager will lead many of the program’s EHE systems coordination and technical assistance efforts. These efforts include the support of content creation management, technical assistance management, and systems-level engagement of health departments and other healthcare delivery systems. Technical assistance responsibilities include supporting EHE jurisdictions and ensuring that all technical assistance/systems coordination requests are resolved promptly and efficiently.
Senior Manager, Health Systems Integration
This NASTAD team member will provide programmatic support and leadership to NASTAD’s Health Systems Integration team while ensuring the alignment of NASTAD’s technical assistance, capacity building, and advocacy work as it relates to insurance coverage (including the Centers for Medicare & Medicaid Services) and access, public health financing, and partnerships, health systems integration and population health data. The Senior Manager, HSI is integral to the implementation of major components of the Health Systems Integration portfolio across federal cooperative agreements related to various areas that support Ending the HIV Epidemic efforts such as health care financing (340B pricing), health systems strengthening (policies and procedures), and healthcare access (ADAP and RWHAP) and wells as health systems modernization (data integration and data systems design) through systems coordination and leveraging population health data integration to achieve improved outcomes. This role plays a vital role in supporting NASTAD’s strategic priority areas through, supporting public health partnerships, programmatic strategies, learning and analyzing evidence to determine best practices. The Senior Manager will provide overall technical expertise in some of the following area: drug pricing, dissemination and replication of evidence information intervention and promising system integration practices, health care access, policy, and legislative affairs.
Associate Director, Health Systems Integration
This NASTAD team member will provide strategic and programmatic leadership to NASTAD’s Health Systems Integration team to ensuring the alignment of NASTAD’s technical assistance, capacity building, and advocacy work as it relates to insurance coverage (including the Centers for Medicare & Medicaid Services) and access, public health financing, and partnerships, health systems integration and population health data. The Associate Director, SIS will be a part of the Organizational Leadership Team (OLT) and is integral to the implementation of major components of the Health Systems Integration portfolio across federal cooperative agreements related to various areas that support Ending the HIV Epidemic efforts such as PrEP financing, health systems strengthening, and healthcare access and financing and wells as health systems modernization through systems coordination and leveraging population health data integration to achieve improved outcomes. This role plays a vital role in supporting NASTAD’s strategic priority areas through, supporting partnerships, programmatic strategies, learning and analyzing evidence to determine best practices. The Associate Director will provide overall technical expertise through in some of the following area: drug pricing, dissemination and replication of evidence information intervention and promising system integration practices, health care access, policy, and legislative affairs.
EHE Program Coordinator – Palm Beach County
The Palm Beach County Ending the HIV Epidemic Program is hiring for a Program Coordinator. This is a new position that will work on much of the administrative planning, reporting and implementation of our EHE activities. This position coordinates and supervises assigned programs or projects involving contracts and grants. Provides support for public outreach intended to broaden and enhance the general public's knowledge of issues related to the Ending the Human Immunodeficiency Virus (HIV) Epidemic Program. Directs and coordinates the planning, implementing and monitoring of EHE services for people with HIV. Initiates, markets and coordinates all activities of programs/projects/contracts/grants. Develops contracts related to the work of the EHE initiative and monitors implementation; develops grant budgets; assists with preparation of program budgets; serves as related program information and referral source; liaises with other County, state, federal and community agencies. Work is performed under general supervision of an administrative superior and is reviewed through conferences, reports and evaluation of results obtained.
To apply please visit this link and search for the position by name "Program Coordinator" or Department "Community Services/Ryan White Act Care Program" and select "apply"
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.
News
The debt ceiling deal could make America’s STD problem much worse
“Senior Biden administration officials and public health leaders are warning that debt ceiling negotiations around clawing back unspent Covid-19 money would have an unintended consequence: increasing sexually-transmitted diseases. The potential cuts — one of the few seeming areas of agreement between House Republicans and the White House — could sap as much as $30 billion from state and local public health departments that are struggling to rebuild as Covid-19 wanes. Funding clawbacks would undermine work to slow the spread of syphilis, chlamydia, gonorrhea, HIV and hepatitis, and leave the country weaker in the face of future pandemics.”
To Eliminate HCV Among Persons Who Use Drugs: Embrace The Complexity
“While referencing with enthusiasm the White House’s recent proposal to eliminate HCV in the U.S., Trooskin warned that “it’s not enough to have the gas … we have to also build the car”—meaning that increasing the availability of direct acting antiviral agents (DAAs) to cure HCV infection, by itself, will not guarantee that vulnerable populations will initiate and be maintained in HCV treatment until they are cured.”
A new nasal spray to reverse fentanyl and other opioid overdoses gets FDA approval
“U.S. health regulators on Monday approved a new easy-to-use version of a medication to reverse overdoses caused by fentanyl and other opioids driving the nation's drug crisis. Opvee is similar to naloxone, the life-saving drug that has been used for decades to quickly counter overdoses of heroin, fentanyl and prescription painkillers. Both work by blocking the effects of opioids in the brain, which can restore normal breathing and blood pressure in people who have recently overdosed… It's not immediately clear how the new drug will be used differently compared to naloxone, and some experts see potential downsides to its longer-acting effect. The drug will be available via prescription and is approved for patients 12 and older.”