Ending the HIV Epidemic Newsletter

By Mike Weir August 24, 2020

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), will begin distributing a monthly newsletter to Phase 1 Ending the HIV Epidemic: A Plan for America jurisdictions. The newsletter will inform recipients of EHE related policy updates, communications from federal partners, success stories, and any other related EHE information. For questions, comments, or content contributions, please contact Mike Weir

Administration Updates

PS20-2010 Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States 

The Centers for Disease Control and Prevention (CDC) announced $109 million in awards for PS20-2010: Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States. For Component A, CDC awarded $106 million with awards ranging from $1.9 million to $10.6 million. CDC distributed the available funding based on the severity of the epidemic and the number of focus counties within each state. As part of Component C, CDC also awarded $3 million to seven state and local health departments to scale up HIV prevention services in STD clinics. PS20-2010 is a five-year cooperative agreement. 

The AHEAD Dashboard 

The U.S. Department of Health and Human Services (HHS) launched a new online resource/tool, America’s HIV Epidemic Analysis Dashboard (AHEAD), to measure collective progress in reaching EHE goals. The dashboard is housed on HIV.gov

The AHEAD dashboard will make HIV data more widely available. It will graphically visualize data for each of the 57 EHE Phase I jurisdictions and track national and jurisdiction progress on six indicators

  • HIV incidence 
  • Knowledge of HIV status 
  • HIV diagnoses 
  • Linkage to HIV medical care 
  • Viral suppression 
  • PrEP coverage 

On August 4, 2020, HHS hosted an informational webinar on America’s HIV Epidemic Analysis (AHEAD) dashboard for local and state health department officials. The webinar was an opportunity to see how data supports EHE, review the six EHE indicators and available data, walk through the dashboard, and answer questions. Click to watch the recording  of the webinar, view the slides, and download the transcript

CDC Updates: EHE Accomplishments & Second Year Plans 

The CDC has released resources highlighting what has been achieved in the first year of the EHE Initiative and plans for the second year of EHE. 

PS19-1906 Deadline Extended to December 31st Notice-of-Funding-Opportunity (NOFO) 

The deadline to submit final/updated EHE plans through PS19-1906 Component B has been extended to December 31. CDC extended the deadline to accommodate changes in organizational capacity among health department staff due to the COVID-19 pandemic. 

EHE Success Stories from Pilot Sites 

“In Louisiana’s East Baton Rouge Parish, the rate of people living with HIV is three times higher than the national average, but leadership from across the community has galvanized the parish to end HIV. With support from the federal EHE initiative, East Baton Rouge is launching innovative efforts to expand HIV diagnosis, treatment, and prevention services — and learning lessons that will jumpstart national efforts to end the HIV epidemic.” 

New CDC HIV Surveillance Data Tables 

The Centers for Disease Control and Prevention (CDC) published four new HIV Surveillance Data Tables. The data included in the HIV Surveillance Data Tables are an expansion of the data released in the 2018 HIV Surveillance Report (Updated), which was released in May 2020. The following data will be updated and published every spring:  

The fourth set of data tables released includes data on core indicators for the Ending the HIV Epidemic (EHE) initiative:  

Legislative Updates

FY2021 Appropriations Updates  

The House is continuing to pass Fiscal Year (FY) 2021 appropriations bills. Last week, the chamber passed a second minibus that includes Labor-HHS, Defense, Commerce-Justice-Science; Energy and Water; Financial Services; and Transportation-HUD spending bills.   

The Partnership to End the HIV, STD, and Hepatitis Epidemics issued a statement responding to the House Appropriations Committee’s proposed Labor-HHS funding bill for FY2021. The statement emphasizes that Congress must fund our public health infrastructure to end racial inequities, infectious disease and the HIV, STD, and hepatitis epidemics.   

Senate appropriators have not yet come to an agreement on what kind of amendments will be considered appropriate and are therefore unable to move forward. In particular, the coronavirus is one major sticking point, and Senate Appropriations Committee (SAC) Chairman Richard Shelby (R-AL) is predicting that a continuing resolution (CR) lasting from September to late November or early December will be necessary.  

The Administration’s FY2021 Budget proposal includes $716 million for the second year of the Ending the HIV Epidemic: A Plan for America (EHE) initiative to eliminate HIV in America.  

While progress on FY2021 appropriations is encouraging, crises, elections, and politics will make enactment of these spending bills unlikely before September 30th—the end of the federal fiscal year. Moving forward, expect talk of government shutdown and, likely, a temporary funding measure to continue government operations until after the November elections. Republicans and Democrats will recalibrate after November, and, especially if the political landscape shifts due to a change in Presidential and/or Senate leadership, one or more of the FY2021 appropriations bills may have to wait until next year for enactment.  

Resources

NASTAD Webinar Series: Effectively Engaging Community in the Ending the HIV Epidemic Process Through Digital Technology 

In collaboration with Kaiser Family Foundation (KFF), NASTAD is hosting a webinar series titled Effectively Engaging Community in the Ending the HIV Epidemic Process Through Digital Technology. The series, which launched in June 2020, aims to support health departments and community-based organizations (CBOs) to accelerate jurisdictional efforts toward Ending the HIV Epidemic. To register for the remainder of the webinar series, please click here.  

  • Learning How to Apply Digital Technology to HIV Community Planning
    • Date: June 25, 2020 at 3:00 – 4:00 PM EDT 
    • This webinar set the foundation around community engagement principles and the relationship between digital technology and community engagement. Peer jurisdictions shared how they have integrated web-based platforms into the HIV planning council activities and EHE community feedback sessions. 
    • A recording of the webinar can be found here.  
  • Exploring Digital Resources and Strategies to Expand HIV Services to Community 
    • Date: July 14, 2020 at 2:00 – 3:00 PM EDT 
    • This webinar delves into the various digital and online platforms available to jurisdictions, their utility and reach, and how they can best support/facilitate community engagement.  
    • A recording of the webinar can be found here
  • Determining the Best Monetary Value When Using Digital Technology 
    • Date: September 16 at 2:00 – 3:00 PM EDT 
    • This webinar will explore the financial and funding components needed to support digital technology. Topics will include how EHE funding can support digital technology, the costs of certain aspects (e.g., buying an ad versus posting a message, traditional media versus digital media costs, etc.), and how to get the best value out of platforms (cost per share, audience reach, etc.). 
    • To participate in the final webinar, please register here.  

EHE Stories from the Field 

NACCHO conducted a brief survey to assess local health departments’ (LHDs) HIV self-testing capacity and challenges. The survey highlighted a need for information about the variety of approaches health departments use to implement innovative HIV testing strategies. To fill that need, NACCHO has launched this ‘Stories from the Field’ series on HIV self-testing programs at LHDs.  

The first story focuses on Denver Public Health’s HIV self-testing program, in which the health department distributes coupon codes to clients to redeem for oral HIV self-tests on Orasure’s website. Using the coupon code model, Denver maintains a successful self-testing program even with limited staff capacity. 

The second story focuses on an innovative partnership between Baltimore City Health Department and Johns Hopkins’ JHU’s I Want the Kit (IWTK), a public health initiative providing easy and confidential STI testing in Maryland since 2004.  In Baltimore, residents can order swabs for HIV, chlamydia, gonorrhea, and trichomonas testing online to self-collect samples in their home or other private location. 

The Toolkit for Technology-based Partner Services 

“CDC has released the updated Toolkit for Technology-based STD and HIV Partner Services to support health departments, community-based organizations, and others in improving their use of technology to reach persons potentially exposed to STDs, including HIV.” 

Ready, Set, PrEP 

In December 2019, HHS announced the launch of Ready, Set, PrEP, a key component of the EHE initiative. The nationwide program will provide Truvada or Descovy at no cost for qualifying recipients. To qualify, recipients must: 

  • Lack prescription drug coverage 
  • Be tested for HIV with a negative result 
  • Have a prescription for PrEP 

All patients enrolled in the Ready, Set, PrEP program fill their prescription at their choice of participating pharmacies or via mail order. 

HHS announced that TrialCard will serve as the new disturber for RSP, replacing Gilead. TrialCard was awarded a $4 million one-year contract with four one-year option periods. Under the contract, TrialCard will:  

  • Verify participant eligibility 
  • Enroll eligible individuals 
  • Maintain the network of participating pharmacies 
  • Distribute the donated medications to uninsured participants 
  • Process requests for the distributed medications.  

The new contract will start November 1, 2020. Since September 2019, distribution of RSP medications was provided by Gilead Sciences Inc.. 

Kaiser Family Foundation Releases EHE Tracker 

The Kaiser Family Foundation (KFF) published two new resources for the federal Ending the HIV Epidemic Initiative (EHE). The first resource is an “EHE explainer” which provides an overview of the federal EHE initiative and explores issues that might mitigate or facilitate its success. The second resource is an EHE funding tracker that provides up-to-date data on federal EHE funding, including an overview of funding mechanisms by year, agency, grant mechanism, and jurisdiction. KFF also released an overview of domestic HIV funding in the FY2021 Budget Request. 

PS19-1906 Program Guidance 

The CDC, in conjunction with the Health Resources and Services Administration (HRSA), provides program guidance for Component B of PS19-1906: Strategic Partnerships and Planning to Support Ending the HIV Epidemic in the United States. The program guidance “seeks to ensure robust and diverse community involvement in the development of local plans, which will continue to be refined over time, in partnership with local communities. This program guidance provides additional recommendations on the community engagement process, the development of an epidemiologic profile summary, a situational analysis summary, and planning activities and scenarios.” 

Academy Health Urges Expanding Research Efforts as Prevention 

Academy Health has published the first part of a two-part series advocating for the expansion of health services and health policy research as a tool to drive the EHE Initiative. 

Self-Testing for HIV and STIs through Local Health Departments: Survey Reveals Barriers, Opportunities 

“To better understand the landscape of HIV/STI self-testing at LHDs, NACCHO launched a brief survey to collect information about LHD approaches and challenges to implementing self-testing programs. Survey results demonstrated a large gap in at-home testing capacity in local public health.” 

HIV Self-Testing Analysis  

NASTAD is excited to announce a comprehensive, landscape analysis of HIV self-testing programs across the United States through our new state-by-state maps detailing HIV self-testing and TelePrEP services in honor of National HIV Testing Day on June 27. As programs began to experience disruption in HIV testing and PrEP clinical services as a result of COVID-19, the CDC released guidelines to use self-testing via home specimen self-collection kit or an oral swab-based test whenever lab visits are unfeasible. In early June 2020, NASTAD surveyed its members to learn more about how health departments are providing access to at-home HIV, HCV, STI, and PrEP self-testing services. In all, our review demonstrated that twenty-one jurisdictions currently offer HIV self-testing services. This represents 55% of the jurisdictions that responded to NASTAD’s RFI. Most of these self-testing programs are recent additions to expand the availability of HIV testing services, with more than 70% of programs starting in 2019 or 2020. The complete analysis can be viewed here.   

News

Greater Than AIDS, with Support from Walgreens and Orasure Technologies, to Provide 10,000 Free In-Home HIV Tests to Community Partners 

“With in-person health services limited due to COVID-19, Greater Than AIDS, a public information initiative of KFF, and Walgreens today announced a new program to provide 10,000 OraQuick® In-Home HIV Test kits to support expanded testing options in high-need areas. Local health agencies and community-based organizations will distribute the FDA-approved, self-administered tests at no cost to those unable to get tested in person.” 

We Can’t End AIDS Without Fighting Racism 

“The color of your skin should not determine the quality of your health. But in the United States, the HIV/AIDS epidemic is exacerbated by racism, bias, and discrimination. As America continues its long-overdue reckoning with racism and systemic injustice, we must address the devastating impact of the disease on the Black community. An end to the AIDS epidemic can only be achieved through dignity, respect, love, and compassion for all.” 

DHEC seeks stakeholder input for state HIV prevention initiative 

“As part of the “End the Epidemics SC” initiative — which is a statewide campaign launched in the fall of 2017 to help stop the intersecting epidemics of HIV, STDs, viral hepatitis and substance abuse — DHEC is asking individuals living with HIV, caregivers, social workers, medical professionals and advocates to take part in a series of online forums geared at identifying any gaps or barriers that exist in delivering HIV prevention and care services in South Carolina.”