Ending the HIV Epidemic Newsletter

By Mike Weir September 30, 2021

September 2021 EHE 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 community. For questions, comments, or content contributions, please contact Mike Weir

Hill Happenings

Reconciliation and FY2022 Appropriations 

The Senate and House passed a short-term Continuing Resolution (CR) that funds the government through December 3, 2021. The President has signed the CR. The agreement includes $28.6 billion for hurricane and wildfire recovery and $6.3 billion in assistance to refugees from Afghanistan. The CR was needed because none of the 12 regular appropriations bills for FY2022 have been passed in the Senate. Senate appropriators have not advanced committee markups of their spending bills due to disagreements on a top-line spending framework. Senate Appropriations Committee Chair Patrick Leahy (D-VT) said that draft bills will be released in the coming weeks to help accelerate negotiations on a compromise solution for FY2022 funding before the December 3 deadline. 

All the while, House appropriators are moving forward committee text in the Build Back Better Act. Democrats are leveraging the budget reconciliation process to avoid the Senate filibuster and pass Democratic policy priorities in the spending package without Republican support via a party-line majority, but internal disagreements within the party have resulted in protracted negotiations.  

NASTAD will continue to monitor the FY2022 appropriations process to advocate for the highest funding levels on behalf of HIV and hepatitis programs. 

Congressional HIV/AIDS Caucus Co-chairs Introduce Bipartisan Bill to Support Aging PLWH 

On September 17, the co-chairs of the Congressional HIV/AIDS Caucus, Representatives Barbara Lee (D-CA-13) and Jenniffer González Colón (R-PR-At Large), introduced legislation supporting the goals and ideals of National HIV/AIDS and Aging Awareness Day (H.Res.649), which is observed annually on September 18th. The resolution includes ongoing efforts for prevention, care and treatment services, and research programs for communities affected by HIV and especially older people living with HIV in the United States and around the world. The Centers for Disease Control and Prevention (CDC) estimates that more than half of the individuals with HIV/AIDS in the United States are people age 50 and older, highlighting the need to support older communities living with HIV/AIDS. NASTAD endorsed the bipartisan resolution.

Administration Updates

HHS Awards Over $48 Million to Health Centers for Ending the HIV Epidemic Initiative 

On September 16, the Department of Health and Human Services (HHS) awarded over $48 million to 271 health centers located in Ending the HIV Epidemic priority jurisdictions to expand HIV prevention and treatment. The funding will allow health centers supported by the Health Resources and Services Administration (HRSA) to conduct more HIV testing and expand workforce capacity to improve PrEP services and care coordination. Additionally, the awardees are encouraged to partner with community organizations and health departments to facilitate increased linkage to care. 

USPSTF Released Final Recommendation for Chlamydia and Gonorrhea Screening 

On September 14, the United States Preventive Services Task Force (USPSTF) issued a B Grade Final Recommendation in support of screening sexually active women for Chlamydia and Gonorrhea. In particular, the USPSTF recommends that providers screen all sexually active women below the age of 25, and sexually active women 25 years or older if they are at increased risk for infection. Under the Affordable Care Act (ACA), the USPSTF B Grade recommendation supports coverage of chlamydia and gonorrhea screening without cost sharing for most health plans.

CDC Advisory Committee on Immunization Practices Considers Universal Adult HBV Vaccination 

The CDC Advisory Committee on Immunization Practices (ACIP) convened on September 29 to consider public comment on the proposal to recommend universal adult hepatitis B vaccination. ACIP is currently reviewing evidence and opened public comment through September 29 to inform their recommendation before the final vote, likely in December. If the committee votes in favor of the proposal, health payers and providers would boost hepatitis B vaccination for all adults, expanding the limited scope of current risk-based inoculation criteria. 

NIDA Report Finds Dramatic Uptick in Methamphetamine-involved Overdose Deaths 

On September 22, the National Institute on Drug Abuse released a report, Methamphetamine Use, Methamphetamine Use Disorder, and Associated Overdose Deaths Among US Adults, which shows that overdose deaths involving methamphetamine nearly tripled from 2015 to 2019 among people ages 18 - 64 in the United States. The data show that, although the overall number of people that reported methamphetamine use did not increase as dramatically, methamphetamine users are reporting higher-risk patterns of use that contribute to overdose mortality, such as frequent use and concurrent use of other drugs, particularly synthetic opioids like fentanyl. Additionally, the report shows rising rates of methamphetamine use in marginalized populations, especially American Indians/Alaska Natives, Black people, and homosexual or bisexual men.  

Biden Administration to Nominate John Nkengasong to be Global AIDS Coordinator 

After a months-long delay in filling the key global health position vacancy, the Biden Administration is expected to announce its intent to nominate Dr. John Nkengasong to serve as the U.S. Department of State Global AIDS Coordinator. Dr. Nkengasong, a virologist by training from Cameroon, currently leads the Africa Centres for Disease Control and Prevention (Africa CDC). As the Global AIDS Coordinator, Dr. Nkengasong would lead the President’s Emergency Plan for AIDS Relief (PEPFAR), the nation’s signature global health initiative that provides funding for AIDS care abroad. The Biden Administration was criticized by HIV and global health advocates for allowing the Global AIDS Coordinator role to remain vacant during the first month of Biden’s tenure in the White House following the departure of the former Coordinator, Deborah Birx, in February of 2020. NASTAD and the Global AIDS Policy Partnership (GAPP) applauded the Biden Administration for the intention to nominate the Dr. Nkengasong.  

Next PACHA Meeting 

The Presidential Advisory Council on HIV/AIDS (PACHA) will be holding the 72nd full Council meeting virtually on Monday, November, 15 and Wednesday, November, 17, 2021 from 1:00 – 5:00 PM (ET) on both days. The meeting agenda will be posted on the PACHA page on HIV.gov

Resources

2021 National EHE Implementation Technical Assistance Meeting 

NASTAD hosted the 2021 National EHE Implementation Technical Assistance Meeting August 3 – 5. Presentation recordings are now available on the event’s virtual platform. To watch a recording, you will need to log in and navigate to the schedule section of the virtual platform. Click on the session to find the embedded video recording. Access to the virtual platform will be available for at least the next three months. Please reach out to communications@NASTAD.org if you have any questions.  

The meeting showcased CDC’s Let’s Stop HIV Together (Together) campaign. Free digital and print resources are available in both English and Spanish and are aimed at stopping HIV stigma and promoting HIV testing, prevention, and treatment. CDC also provides direct technical assistance and advice on how to maximize use of the campaign. Resources including palm cards, videos, social media toolkits, web banners, and other materials are available at www.cdc.gov/StopHIVTogether or via email at StopHIVTogether@cdc.gov.  

CDC NOFO: Comprehensive High-Impact HIV Prevention Programs for Young Men of Color Who Have Sex with Men and Young Transgender Persons of Color 

The purpose of this program is to implement comprehensive high-impact HIV prevention programs to address health disparities among Young Men of Color Who Have Sex with Men (YMSM), Young Transgender Persons of Color (YTG), and their partners with the goal of reducing HIV transmission and HIV-associated morbidity and mortality. Letters of Intent are due October 4, 2021 to CBOFOA@cdc.gov. The application deadline is November 19, 2021, 11:59 p.m. Eastern Standard Time.

National Gay Men’s HIV/AIDS Awareness Day  

National Gay Men’s HIV/AIDS Awareness Day (NGMHAAD) is observed annually on September 27. NGMHAAD serves as an opportunity to direct attention to the continuing and disproportionate impact of HIV on gay, bisexual, and other men who have sex with men in the United States. Data from 2019 show that 69% of new HIV diagnoses in the United States and dependent areas were among gay and bisexual men; in that same year, an estimated 15% of gay and bisexual men with HIV did not know their status. The disruption of traditional HIV testing services over the last 19 months has made self-testing a great option for some people to take an HIV test, learn their status, and get the benefits of today’s prevention and treatment tools. Click here to read a Dear Colleague letter from the leadership of the CDC National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention on the importance of this year’s NGMHAAD. 

Webinar: The Role of 340B in Ending the Epidemics: FAQs, Tools, and Considerations for the EHE Component C Clinics and STD Programs 

Date & Time: October 12, 2021 at 2:00 PM ET 

The 340B Drug Pricing Program is an instrumental tool in ending the HIV and STD epidemics, enabling sexual health programs to expand and improve services, address health equity, and reduce health disparities. The 340B Program provides covered entities with up-front cost savings on medications, as well as the potential to generate revenue in the form of insurance payments, providing sexual health programs with valuable resources. Cost savings and revenue are reinvested back into sexual health services, expanding programmatic reach, and stretching scarce resources as far as they can go to end the HIV and STD epidemics. Ending the HIV Epidemic Part C Clinics along with STD clinics who receive support from federal HIV, STD, and viral hepatitis grants are eligible for the 340B Drug Pricing Program, and NCSD is providing templates, toolkits, and technical assistance to support STD and sexual health clinics in leveraging the 340B Drug Pricing Program to support their efforts in ending the epidemics.  

CDC MMWR: Increasing Access to HIV Testing Through Direct-to-Consumer HIV Self-Test Distribution — United States, March 31, 2020–March 30, 2021 

“During March 2020–March 2021, a novel public-private partnership provided free HIV self-test kits directly to men who have sex with men (MSM). Most participants reported they had never tested (36%) or tested >1 year ago (56%); approximately 10% reported accessing services including sexually transmitted infection testing and preexposure prophylaxis after using the self-test. The data suggest that public funding of HIV self-testing can engage MSM who never previously tested and might increase HIV testing frequency among this population.” 

This MMWR assessed the outcomes of the TakeMeHome program. NASTAD released this blog highlighting the program and the MMWR’s release.

NASTAD Information Brief & Webinar: What about Post-Exposure Prophylaxis (PEP)? PEP Implementation in the South.”   

Published in both English and Spanish, this brief provides an overview of HIV Post-exposure Prophylaxis (PEP) in the southern United States (“the South”). The goal is to provide an overview of prevention with PEP to drive collective action between: jurisdictional and local public health departments, community-based organizations (CBOs), and community health clinics, to increase and improve prevention with PEP. Increasing PEP utilization as an effective prevention method is necessary for EHE and reaching EHE goals and objectives, particularly within the context of the South.   

NASTAD Issue Brief: Pharmacy-Initiated  PrEP  and PEP 

NASTAD released a new resource, Pharmacy-Initiated PrEP and PEP. This resource was developed after researching various proposed and enacted bills throughout the country related to pharmacist’s ability to dispense Pre-Exposure Prophylaxis (PrEP) and PEP without a prescription from a medical provider. 

This brief examines the opportunities and challenges with pharmacy-initiated PrEP and PEP treatment, offers considerations for states, pharmacists, and other entities looking to explore pharmacy-initiated PrEP and PEP treatment, and describes the current legal and statutory landscape around pharmacy-initiated PrEP and PEP.     

The brief includes a legislative tracker of proposed and enacted state and federal laws that help pharmacists dispense PrEP and PEP. The legislative tracker will be periodically updated to reflect newly proposed, passed, and enacted bills throughout the country.   

In conjunction with this released resource, NASTAD hosted a webinar on Pharmacy Initiated PrEP and PEP. A recording of the webinar will be published on the EHE website.

CSTE LEAD: Leading Epidemiologists, Advancing Data 

The Council of State and Territorial Epidemiologists (CSTE) is pleased to support a second cohort of our leadership training program for mid-career epidemiologists: CSTE LEAD: Leading Epidemiologists, Advancing Data. Preview the application before submitting the application by October 17, 2021. 

CSTE LEAD is a 12-month project-based leadership development program with twice a month meetings. Participants should expect to spend up to 4 hours each month on training activities in addition to time spent on their projects. Applicants should have at least five years of public health work experience and be in a position to lead a project. The informational webinar recording and additional program information can be found online.

For questions, email Jessica Arrazola at WFResources@cste.org

TakeMeHome Program Expands to Offer STD Test Kits  

NASTAD continues to partner with Building Healthy Online Communities (BHOC) on a free HIV and STD test kit home delivery program, TakeMeHome. BHOC and NASTAD created a seamless process to handle payment from health jurisdictions, which will be promoted by Grindr to users who live in city or states included in the program. For more information about the program, contact Natalie Cramer or Kendrell Taylor.  

Systems Coordination Provider Project Updates 

NASTAD Systems Coordination Provider (SCP) staff continues to participate in HRSA Ending the HIV Epidemic Programmatic Site Reviews through February 2022. NASTAD SCP staff attended four visits in September. The site visits 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. 

CAI WebinarBeyond the Walls: Building Bridges for Post-Release Linkages to Care & Community 

Date & Time: Thursday, October 14, 2021, from 1:00 - 2:00 PM ET 

CAI will host a Beyond the Walls: Building Bridges for Post-Release Linkages to Care & Community webinar on Thursday, October 14th, 2021, from 1:00 PM- 2:00 PM ET. 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. Please click on the registration link to register for this webinar and view additional details.   

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

Financing Comprehensive PrEP Access to End the HIV Epidemic 

“We are in a moment of urgent and necessary innovation for HIV prevention. Our present approaches to scale up biomedical prevention options such as pre-exposure prophylaxis (PrEP) have largely failed…To end the HIV epidemic and address the unequal and insufficient use of PrEP in the United States, we must make PrEP access simple. Make. It. Simple.” 

Johns Hopkins Medicine mathematical model to play major role in ending HIV nationwide 

“A new Johns Hopkins Medicine mathematical model to predict how the human immunodeficiency virus (HIV) spreads in urban areas will play a major role in a federal initiative aiming to reduce the incidence of HIV infections in the United States by 90% between 2020 and 2030. As part of the EHE program, the model will be used to forecast HIV incidence in 32 U.S. cities when implementing specific interventions to reduce transmission of the virus.”