Ending the HIV Epidemic Newsletter

By Mike Weir May 26, 2021

May 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

Administration Updates

CDC Releases 2019 National Viral Hepatitis Surveillance Report  

On May 19, the Centers for Disease Control and Prevention (CDC) released the 2019 National Viral Hepatitis Surveillance Report. The annual report serves as a summary of national viral hepatitis surveillance data based on reporting of cases of hepatitis A, B, and C from January 1 through December 31, 2019. The 2019 report details significant increases in rates of hepatitis A and C: from 2015 through 2019, there was a 1300% increase in cases of acute hepatitis A and a 63% increase in cases of acute hepatitis C. The report shows stable rates of acute hepatitis B cases from 2015 through 2019. Additionally, the 2019 report included new data parameters and content, such as demographic characteristics for persons living with chronic hepatitis B and C, the number and rate of viral hepatitis cases by urbanicity status, and outcome data from the CDC’s Perinatal Hepatitis B Prevention Program. The annual National Viral Hepatitis Progress Report is expected to be released later this month.

Biden Administration to Invest $7 Billion from American Rescue Plan to Hire and Train Public Health Workers in Response to COVID-19 

On May 13, the Biden Administration announced a $7.4 billion investment, authorized by the American Rescue Plan, to expand the public health workforce in order to alleviate the demands of the COVID-19 pandemic on health departments and improve the nation’s public health infrastructure to facilitate pandemic preparedness.

State and local health departments will receive $4.4 billion to increase staff capacity to support COVID-19 response efforts in both the short and the long term. Of the funding, $1.13 billion will be allocated over five years to increase state and local capacity to conduct case investigation and contract tracing with a focus on strengthening the disease intervention specialist (DIS) workforce, adding a total of about 9,000 to 10,000 new DIS. In addition to the workforce funding, $3 billion will be used to create a new program at the CDC that will provide under-resourced health departments the ability to hire staff with a focus on staff representing communities they serve. CDC will be working with stakeholders to develop this program. NASTAD applauds the Biden Administration on this investment in the public health workforce, particularly DIS. We will continue to provide updates as they are available. 

Biden Administration Appoints New HHS Deputy Assistant Secretary for Population Affairs  

On May 10, the Biden Administration announced that Jessica Marcella has been appointed as the Department of Health and Human Services (HHS) Deputy Assistant Secretary for Population Affairs. As head of the Office of Population Affairs (OPA), Marcella will oversee the administration of the Title X family planning program, the Teen Pregnancy Prevention Program, and other reproductive and adolescent health initiatives, including policy on contraception and STIs. Marcella will be tasked with rebuilding the Title X program following the Biden Administration’s decision to issues new rulemaking in order to reverse harmful changes implemented by the Trump Administration. 

HHS 40th Anniversary Webinar: 40 Years of Progress: It’s Time to End the HIV Epidemic 
The HHS Office of Infectious Disease and HIV/AIDS Policy (OIDP) will host a webinar to commemorate the 40th anniversary of the CDC’s Morbidity and Mortality Weekly Report (MMWR) on the first reported cases of what would be known as AIDS. This webinar will reflect on the 40 years of progress and highlight the best practices and innovations across the U.S. to help us end the HIV epidemic. The webinar will be Tuesday, June 1  from 12:00-3:30 PM ET. Please register here.

Legislative Updates

FY2022 Appropriations 

On Wednesday, May 19, the Senate Finance Committee held a hearing entitled “Review of the FY2022 Budget Blueprint for the Centers for Disease Control and Prevention.” CDC Director Dr. Rochelle Walensky and CDC Principal Deputy Director Dr. Anne Schuchat testified before the committee on the CDC’s priorities for the upcoming fiscal year. Director Walensky called for long-term investments in flexible public health infrastructure to improve health equity and better address social determinants of health. Additionally, Director Walensky highlighted the need to address systemic racism in public health and the worsening substance use and opioid epidemic, including the infectious disease consequences related to drug use.  

NASTAD joined over 225 national and local organizations and called on Congressional Appropriators to increase funding for the Infectious Diseases and the Opioid Epidemic program at the CDC. The advocates call for increased investments in harm reduction providers like Syringe Service Programs (SSPs) to expand access to preventive services and link drug users to care. The coalition also calls for the removal of the ban on the use of federal funds to purchase syringes, a pivotal cost-prohibitive hurdle that many SSPs struggle to overcome before serving their communities. The advocates highlight the critical need for the funding amid burgeoning rates of substance use and overdose deaths, particularly among communities of color. 

Senate Confirms CMS Administrator Nominee  

On May 25, the Senate confirmed the nomination (55-44) of Chiquita Brooks-LaSure as Administrator of the Centers for Medicare and Medicaid Services (CMS). Brooks-LaSure will play a key role in implementing the Biden Administration’s health agenda, including revoking Medicaid work requirements and expanding access to coverage. Brooks-LaSure, the first Black woman to serve as CMS Administrator, has extensive healthcare experience, including a former role at CMS during the Obama Administration.  

Resources

NASTAD Webinar: Introducing NASTAD’s Racial Equity Collaborative for Drug User Health 

Date: Thursday, June 3 from 4:00 – 5:00 PM EST 

NASTAD will be hosting a webinar to announce the inaugural Racial Equity Collaborative for Drug User Health: A Pilot Program for People of Color, taking place in Summer 2021. The Collaborative is intended to support a cross-generational and cross-career cohort of up to twelve BIPOC individuals currently working in the harm reduction and drug user health fields with or within public health systems across the United States. This may include people currently based in state or local health departments that do drug user health work, independent or grassroots and community-based harm reduction organizations, drug policy advocacy, and/or public health research focused on drug use. This cohort is being supported by Reframe Health and Justice and Healing Equity United.  To join the webinar, please register here.  

NASTAD Webinar: Scaling Up HIV Workforce Capacity for Ending the HIV Epidemic 

Date: Wednesday, June 9, from 2:00 to 3:30 PM ET 

NASTAD is pleased to announce a three-part webinar series Scaling Up HIV Workforce Capacity for Ending the HIV Epidemic. The series will focus on addressing the needs and challenges faced by health departments and community partners as they work to implement their Ending the HIV Epidemic plans. The series will also highlight the importance of community representation in the HIV workforce. The initial webinar will focus on identifying workforce gaps and needs of health departments and community partners by highlighting important considerations when evaluating and measuring the HIV workforce. NASTAD will review the workforce challenges of health department HIV programs during the COVID-19 pandemic as shared through a 2020 request for information. The Council of State and Territorial Epidemiologists (CSTE) will share tips and tools on evaluation and measurement, and Mecklenburg County, an Ending the HIV Epidemic (EHE) Phase 1 Jurisdiction will share their experience with conducting a workforce capacity assessment as a part of their EHE planning.  

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. The program has already distributed more than 5,000 HIV test kits in eight states around the U.S. and is now expanding to include test kits for syphilis, gonorrhea, and chlamydia. 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

Self-Testing Webinar Series Update   

NASTAD is pleased to announce the release of a new toolkit entitled “Self-Testing: A Strategy to Improve Access to HIV, Viral Hepatitis, and STI Testing”. NASTAD, in partnership with the Association of Public Health Laboratories (APHL), developed this toolkit to help health departments, public health laboratories, and their community partners decide whether and how to incorporate self-testing for HIV, viral hepatitis, and STIs. The toolkit is designed to support health departments in their efforts to strengthen HIV, viral hepatitis, and STI testing and linkage programs.  

The toolkit provides an overview of self-testing models; the roles of HIV, viral hepatitis, and STI programs, and public health laboratories in supporting self-testing; and a discussion of the benefits and drawbacks of self-testing. Also included are tools that health departments can use to evaluate self-testing as a public health strategy, a summary of currently available commercial self-testing services, and detailed recommendations and “tips” from health departments that have implemented self-testing.   

The toolkit includes case studies of selected health department-supported self-testing programs. The case studies provide detail about the self-testing models employed by health departments, including recruitment and operational details, along with lessons learned that other health departments might find helpful.   

The toolkit was previewed in the final webinar of the Self-Testing Series held on April 6, 2021. The recording of the final webinar, slides presented and previous webinars in the series can be accessed on NASTAD’s EHE Microsite. NASTAD and APHL encourage you to share these resources widely with other health department staff, testing and linkage providers, laboratories, and others. For additional questions about the toolkit, please contact Kendrell Taylor (NASTAD), Liisa Randall (NASTAD Consultant), or Anne Gaynor (APHL). 

CDC BlogSTD Clinics Contribute to Ending the HIV Epidemic in the United States 

STD clinics play a key role in HIV diagnosis, prevention, care, and treatment. The CDC recognizes this role and in August 2020 awarded $3 million to seven jurisdictions to scale up HIV services in eight STD clinics through funding announcement PS20-2010: Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States (EHE) CDC will support these STD clinics as they expand HIV services, including assistance in monitoring and evaluating clinic and patient outcomes. Measuring the impact of EHE STD clinic efforts will help to identify best practices to end the HIV epidemic and reduce the rates of STIs in the US.”

MMWR: Trends in Diagnosis of HIV Infection, Linkage to Medical Care, and Viral Suppression Among Men Who Have Sex with Men, by Race/Ethnicity and Age — 33 Jurisdictions, United States, 2014–2018 

STI Express Initiative 

With funding from the CDC’s Division of STD Prevention (DSTDP), NACCHO leads the STI Express Initiative, which is designed to increase the evidence base for express STI clinical visits and support clinics in quality improvement efforts to strengthen, scale-up, and evaluate STI express models. Resources on the homepage provide access to reports, case studies and tools for clinics implementing express STI services.  

NACCHO Webinar: Using M&E to Better Serve Your Community: A Four-Part Webinar Series for Health Departments and SSPs 

This four-part webinar series will explore how syringe services programs (SSPs) can use monitoring and evaluation (M&E) to better serve their clients and communities. M&E includes the collection, management, analysis, reporting, and use of program data to inform program planning and improve program efficiency and effectiveness. M&E can help SSPs better identify, respond to, and anticipate community needs; address gaps in service provision; and identify areas for growth. SSPs can also use M&E data to demonstrate their impact or address community concerns or opposition to harm reduction, which can be useful when applying for funding, strengthening community partnerships, or influencing local policies and regulations.  

Issue Brief: Meeting the Needs of People Aging with HIV on the Path to Ending the HIV Epidemic 

“More than half of people living with HIV in the United States are aged 50 or older, and a growing number of people are living and aging with HIV into their 70s and beyond. Concerted action is needed to meet the needs of older people living with HIV. The burdens of HIV, aging, and related health comorbidities, combined with the social and structural challenges that people aging with HIV face, necessitate not only a focus on HIV-related outcomes, but also a comprehensive response aimed at treating comorbidities and improving long-term health and quality of life.” 

NACCHO Webinar: Eliminating Viral Hepatitis in Pennsylvania: Mobilizing Partners and Addressing Syndemics through Micro-Elimination 

For Hepatitis Awareness Month 2021, NACCHO hosted a webinar highlighting how state and local health departments in Pennsylvania are mobilizing partners to eliminate viral hepatitis and tackle the syndemic of viral hepatitis, HIV and other STIs, and substance use. The webinar included an overview of hepatitis elimination across the US, including the critical role played by local health departments, followed by a deeper dive into hepatitis elimination in Pennsylvania. Speakers from the Pennsylvania Department of Health, Allegheny County Health Department (Pittsburgh), Philadelphia Department of Public Health, and their local and community partners shared how they collaborate across jurisdictions and highlighted strategies for the micro-elimination of viral hepatitis among pregnant people, people who use drugs, and people living with HIV. 

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

Systems Coordination Provider Project 

NASTAD Systems Coordination Provider (SCP) staff will participate in HRSA Ending the HIV Epidemic Programmatic Site visit reviews through February 2022. The site visits serve as an opportunity for NASTAD (SCP) and Cicatelli Associate Inc. (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.  

Webinar: Finding and Using the Best Data Sources to Support EHE Strategies  

Date: June 17, 2021 from 1:00PM – 2:00 PM ET.  

In this interactive on-line TA event, CAI subject matter experts, who live and breathe data, will provide tips on linking to the best data sources and helping the EHE team in jurisdictions integrate data management into implementation activities. This webinar is intended for EHE jurisdictions, including EHE partners and subrecipients, and is specifically designed for data managers and analysts. To register for this webinar and to view additional details, please visit: Finding and Using the Best Data Sources to Support EHE Strategies | CAI Registration (caiglobal.org)  

Fighting the Syphilis and HIV Epidemics: Voices from the Field 

The National Coalition of STD Directors (NCSD), in partnership with Chembio, is excited to present an informational webinar featuring different presenters from across the nation who will share their experiences using the DPP® HIV-Syphilis Tests in the ongoing HIV and syphilis epidemics. The webinar will be held May 27, 2021 from 2:30 - 3:45 pm ET. Click here to register for the webinar  

Call for Abstracts: NCSD STD Engage 2021 

NCSD invites members and partners to submit presentation and electronic poster proposals for STD Engage 2021, being held virtually October 12-15, 2021. Click here to learn more.  

At Last, Generic HIV Prevention Drugs Promise Savings And Access—But Also Reveal Precarious Financing 

“Pre-exposure prophylaxis or “PrEP,” a once-daily pill that prevents HIV transmission, has been a game changer for HIV and has helped put the United States on a path to end new HIV infections nationwide. However, PrEP has also exposed the instability of HIV public health financing and its outsized reliance on pharmaceutical manufacturers to prop up not only medication access programs but the basic fabric of the HIV workforce.”  

Opioids, LGBT Health, Covid: HHS’s Levine Has Packed Agenda 

“Rachel Levine has a full plate of health inequities she wants to tackle as the Biden administration’s assistant secretary for health, including Covid-19 vaccinations, LGBT health care, HIV, opioid use, and environmental impacts on health. Because of her position as the highest ranking openly transgender official in any administration, she is facing pressure to be a voice for her community and make a real impact on health policy in the next few years. The role of assistant secretary for health at the Health and Human Services Department is often shaped by its holder, with the authority to address a multitude of public health issues and a limited amount of time to do so.”