Ending the HIV Epidemic Newsletter

By Mike Weir October 28, 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), 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.

Administration Updates

Ending the Epidemic Stakeholder Webinar

On Thursday, October 29, 2020, the Department of Health and Human Services (HHS) Office of Infectious Disease and HIV/AIDS Policy (OIDP) will host a stakeholder webinar on efforts to implement the Ending the HIV Epidemic: A Plan for America (EHE) initiative. The webinar will be held from 2:00-3:30 PM ET. Click here to register.  

PACHA Virtual Meeting

The Presidential Advisory Council on HIV/AIDS (PACHA) will hold its 69th full Council meeting virtually on Wednesday, December 2, and Thursday, December 3, 2020 from 1:00-5:00 PM ET. The meeting agenda will be posted on the PACHA page on HIV.gov prior to the meeting. Instructions on attending this meeting virtually will be posted one week prior to the meeting here.

AHEAD Dashboard Updated to Reflect 2020 Data on Two Key Indicators

America’s HIV Epidemic Analysis Dashboard (AHEAD), an online HIV data visualization tool, has been recently updated. AHEAD offers graphical representations of data on the six EHE HIV indicators for the 57 jurisdictions prioritized in the federal initiative, as well as state data for the 21 states in which EHE counties are located. The recent AHEAD update incorporates the preliminary cumulative quarterly 2020 HIV data from the CDC on two key EHE indicators. Data for the years 2019 and 2020 are preliminary.  Due to the impact of COVID-19, please interpret with caution.”

HHS launched America’s HIV Epidemic Analysis Dashboard (AHEAD) to measure collective progress in reaching EHE goals. 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 YRBS Data Summary & Trends Report Released

“CDC released the Youth Risk Behavior Surveillance Data Summary & Trends Report: 2009-2019, which provides an in-depth look at trends in sexual behaviorhigh-risk substance use, experience of violence, mental health, and suicide. Risk behaviors co-occur, and many students experience multiple risks across these four priority areas that are closely linked to HIV and STD risk.

This 2020 report examines 24 variables and includes three new health behaviors—recent prescription opioid misuse, STD testing, and HIV testing. It also provides data on the health behaviors and experiences of sexual minority youth from the 2015, 2017, and 2019 cycles of the national Youth Risk Behavior Survey (YRBS), allowing trends to be reported for this population for the first time.”    

National Latinx AIDS Awareness Day

October 15 was National Latinx AIDS Awareness Day (NLAAD). The Centers for Disease Control and Prevention (CDC) provided free tools in the NLAAD Resource Center to help in supporting awareness activities and testing events. 

Fiscal Year 2021-2025 NIH Strategic Plan for HIV and HIV-Related Research

“The National Institutes of Health (NIH) Office of AIDS Research (OAR) released two key documents to guide the NIH HIV research program for years to come: (1) The FY 2021–2025 NIH Strategic Plan for HIV and HIV-Related Research, and (2) the FY 2021–2025 Notice (NOT-OD-20-018), which present NIH HIV/AIDS Research Priorities and Guidelines for Determining HIV Funding. The FY 2021–2025 Plan serves as the guiding framework for OAR to allocate funds to the NIH Institutes, Centers, and Offices that advance the NIH-wide HIV research agenda and ensure investment of resources in the highest priority areas.” 

NOFO PS21-2102: Comprehensive High-Impact HIV Prevention Programs for Community-Based Organizations

The CDC released the Notice of Funding Opportunity (NOFO) PS21-2102: Comprehensive High-Impact HIV Prevention Programs for Community-Based Organizations. Letters of Intent were due September 30, 2020 to CBOFOA@cdc.gov. The application deadline is November 20, 2020, 11:59 PM ET. For additional information, please visit the PS21-2102 website.

Health Department Call for Abstract Submission – Special Journal Issue

The American Journal of Preventive Medicine and CDC are inviting submissions from health departments and their academic partners for a thematic supplement titled “The Evidence Base for Initial Intervention Strategies for Ending the HIV Epidemic in America.” CDC is interested in health department program experience and evidence of best practices for implementing the EHE strategies identified in the PS20-2010 NOFO. Topics may focus on strategies for implementing any of the EHE pillars: Diagnose, Prevent, Treat, or Respond. If you are interested in contributing a paper, please provide a 350-word unstructured abstract summarizing the paper’s topic by Friday, November 6, 2020. Please submit abstracts to Dawn Smith at dsmith1@cdc.gov. Local EHE counties are encouraged to submit abstracts to this special journal issue.

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.

Legislative Updates

COVID-19 Relief Updates

Congressional and Administration leaders remain in a deadlock over another round of COVID-19 stimulus. The House released and passed an updated version of the Health and Economic Recovery Omnibus Emergency Solutions Act (HEROES) Act, which proposes an additional $100 million for the Ryan White HIV/AIDS Program and $65 million for the Housing Opportunities for Persons with AIDS (HOPWA) Program. The package is unlikely to be taken up by the Senate. NASTAD will continue to monitor the appropriations process and stimulus negations and advocate for the highest funding levels on behalf of HIV and hepatitis programs. 

Resources

Preventing HIV in DeKalb County, Georgia: One Conversation at a Time

“To jumpstart national efforts to end the HIV epidemic, Georgia’s DeKalb County is connecting more people to vital HIV prevention options and empowering them to lead longer, healthier lives. They are doing this by:

Ending the HIV Epidemic: Culturally Attuned Educational Materials for American Indians/Alaska Natives

“As one of several Indian Health Service activities supported by the Minority HIV/AIDS Fund (MHAF) in Fiscal Year 2020, the Urban Indian Health Institute (UIHI) is currently leading a project focused on creating culturally attuned HIV education materials—including print, digital, and video formats—for both American Indian and Alaska Native patients and the healthcare providers who serve them.

Among the new materials being developed under this project, in March 2020, UIHI released a short film, Positively Native , in which long-time HIV survivors Bill Hall (Tlingit), Shana Cozad (Kiowa), and Hamen Ides (Lummi) discuss their lived experiences with HIV stigma, discrimination, and advocacy. Along with the film, UIHI released an accompanying toolkit that includes a facilitator's guide, discussion questions, and a presentation on the basics of HIV. The organization presented Positively Native to an audience of 38 people at the International Indigenous Pre-Conference on HIV/AIDS in July 2020.”

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

In collaboration with Kaiser Family Foundation (KFF), NASTAD hosted a webinar series titled Effectively Engaging Community in the Ending the HIV Epidemic Process Through Digital Technology. The series, which launched in June 2020, aimed to support health departments and community-based organizations (CBOs) to accelerate jurisdictional efforts toward Ending the HIV Epidemic. Recordings of the webinars are listed below:

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’ 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 third story focuses on the Thomas Jefferson Health District (TJHD) and their implementation of  HIV self-tests, a self-administered rapid oral swab, to expand access to HIV testing. TJHD serves 150,000 people in urban areas and another 100,000 in highly rural counties. This unique geographic context can make accessing in-person HIV testing difficult, especially amid the COVID-19 pandemic. When it comes to testing for HIV, many factors may prevent someone from knowing their status, such as stigma, scheduling conflicts, or transportation issues. TJHD’s self-testing program, in which individuals can receive a self-test kit at the clinic or through the mail, offers a low-barrier experience for those who are unable or unwilling to test in person. 

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.”

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.”

Toolkit for Providing HIV Prevention Services to Transgender Women of Color 

The CDC Capacity Building Branch released the Toolkit for Providing HIV Prevention Services to Transgender Women of Color. This technical assistance guide can be used by community-based organizations and others to support HIV prevention services and Ending the HIV Epidemic activities. Access the toolkit here

Talking is Power” Campaign Supports Parents in Educating Native American Youth about HIV 

To help American Indian and Alaska Native parents and caring adults initiate difficult conversations about sexual health topics with their teens and young adults, in Spring 2020 the Healthy Native Youth collaborative launched the Talking is Power campaign. Caring adults can text the word “EMPOWER” to 97779 to receive weekly text messages that include culturally appropriate tips and resources that support conversations with their teens about topics such as sexual health, pregnancy, HIV and STDs, condoms, and consent. Learn more on HIV.gov

News

Scaling up HIV Prevention Services in STD Specialty Clinics

“Today, data show that STD clinics serve a high volume of racial/ethnic minorities, gay and bisexual men, and transgender people, and that they have become a primary source of both STD and HIV prevention services for people without regular access to healthcare. As a result, STD clinics will play a vital role in the nation’s ambitious federal initiative Ending the HIV Epidemic: A Plan for America (EHE). However, these clinics are vastly under-resourced. An FY2020 investment from the HHS Minority HIV/AIDS Fund (MHAF) aims to address that by bolstering training and technical assistance (T/TA) efforts so STD specialty clinics can better provide HIV prevention services.”

Researchers aim to end Miami’s HIV epidemic

“Cianelli’s PrEP initiative is the newest of four University of Miami proposals funded by the National Institutes of Health to advance the federal government’s Ending the HIV Epidemic (EHE) plan. Unveiled by President Donald Trump last year, EHE aims to reduce the roughly 40,000 new HIV cases still diagnosed annually in the United States by at least 90 percent by 2030. And it aims to do so by supporting community-based initiatives that the NIH’s Centers for AIDs Research (CFARs) and the National Institute of Mental Health’s AIDS Research Centers (ARCs) are pursuing with existing and highly effective tools for diagnosing, preventing, and treating HIV.” 

Nimble, Collaborative, Community-Driven: Lessons from Hep Free 2030, Hawai'i's New Hepatitis Elimination Strategy

“Hawai'i has one of the highest rates of liver cancer in the United States. Hepatitis B and hepatitis C are the leading causes of liver cancer in the state and could affect up to 63,000 people across the islands. Most adults at-risk for and living with chronic hepatitis B or chronic hepatitis C do not know it and therefore do not access hepatitis screening, vaccinations and/or treatment. To address this health crisis, Hep Free Hawai'i (HFH) released the state’s first hepatitis elimination plan on July 28, 2020 to coincide with World Hepatitis day.”

Opioid Crisis Also Affects HAV and HBV Rates

“For the last 15 years, hepatitis A virus (HAV) had been associated mostly with international travel to countries where the virus is endemic, and with contaminated food, but current U.S. outbreaks of HAV are now primarily spread by person-to-person contact.”

Among Older Men, HIV Is Linked to Higher Dementia Risk

“HIV is associated with an increased risk for dementia among older men, aidsmap reports. Kirsten Bobrow, DPhil, of the University of California, San Francisco, and her colleagues analyzed data on 2,228 veterans from the U.S. Veterans Health Administration System, covering 2005 to 2015. They published their findings in the journal AIDS. The study included data on 1,114 veterans living with HIV, all of whom were 55 or older. They were matched with 1,114 HIV-negative vets according to age, sex, race and substance use (including tobacco use or unhealthy use of drugs or alcohol).”