On October 1, I joined federal colleagues from CDC and HRSA in a virtual meeting with HIV and viral hepatitis program leaders from state and local health departments. The meeting, organized by NASTAD as the first part of their annual technical assistance meeting, provided an opportunity for sharing updates and engaging in dialogue with these key stakeholders in Ending the HIV Epidemic: A Plan for America (EHE). Much of the conversation focused on EHE as well as the broader response to HIV and other infectious diseases amid the pandemic. Here are some highlights:
Addressing Racial/Ethnic Disparities in HIV
Consistent with their meeting’s theme/focus, NASTAD asked my colleagues and I to discuss specifically how our agencies are working to address Black lives in the context of ending the HIV/HCV epidemics. Both CDC’s Dr. Jonathan Mermin and I reviewed some of the significant racial/ethnic disparities in HIV, including:
- Diagnoses: In 2018, Blacks/African Americans accounted for 13% of the U.S. population, but 42% of the 37,832 new HIV diagnoses in the United States and dependent areas, while Hispanics/Latinos accounted for 27% and Whites accounted for 25%.
- Viral suppression: Smaller proportions of African Americans (60%) and Latinos (64%) with HIV were virally suppressed compared to whites (71%) in 2018.
- Undiagnosed HIV: 42% of the estimated 161,800 people with undiagnosed HIV in the U.S. are African American, 28% Latino, and 24% White.
Some examples of how EHE activities led by the HHS Office of Infectious Disease and HIV/AIDS Policy are addressing the disproportionate impact of HIV among African Americans include:
- Primary audiences for Ready, Set, PrEP: African American gay and bisexual men and African American women ages 18-34 are two of the three primary audiences for the outreach/marketing efforts supporting EHE’s Ready, Set, PrEP program, a nationwide program that provides PrEP medications at no cost to thousands of individuals who qualify. New campaign assets to be launched soon feature actual PrEP users and will include Black individuals who will share their experience using PrEP and what it means to them.
- Improved data collection for Ready, Set, PrEP: In addition, recent changes in our Ready, Set, PrEP enrollment data collection and reporting will enable us to evaluate how well our program is closing the PrEP racial disparity gap.
- Minority HIV/AIDS Fund (MHAF): The FY20 MHAF, which is administered by OIDP, focused its awards on several projects by our HHS partners that strengthen EHE efforts serving racial/ethnic minority populations through HIV testing, prevention, and care and treatment services. You’ll be able to read about those activities in blog posts that have begun appearing on HIV.gov.
Dr. Mermin shared an important perspective about the significant potential of EHE to reduce the disproportionate impact of HIV on African Americans: While 50% of new HIV diagnoses in the U.S. were in EHE phase 1 jurisdictions, 63% of new HIV diagnoses among Black/African Americans and 64% among Hispanic/Latinos were in those jurisdictions. So, success in those jurisdictions will reduce these disparities. The investment of $121 million from CDC to support the development and implementation of EHE plans in each of the 57 jurisdictions, in collaboration with local organizations and community members, along with $63 million awarded to Ryan White HIV/AIDS Program recipients and $54 million for health centers, is providing unprecedented opportunities for communities to innovate, engage new partners, and try new approaches to reach and engage more community members with or at risk for HIV.
Looking ahead, I shared that a centerpiece of OIDP’s current work is coordinating cross-government development of three national strategic plans focused on HIV, viral hepatitis, and sexually transmitted infections that each will provide national roadmaps for 2021-2025. These plans recognize the disproportionate impact of these infectious diseases on various populations, including some racial and ethnic minorities. To focus efforts and resources for the greatest impact on outcomes for the nation, each of the draft plans designates several priority populations based on national-level data about the disproportionate impact of each disease. For example, the draft HIV National Strategic Plan designates both Black gay and bisexual men and Black women as priority populations. Similarly, the Draft Viral Hepatitis National Strategic Plan designates non-Hispanic Blacks as priority populations for both hepatitis C prevalence and mortality.
Effects of COVID-19 on HIV Services
During the conversation with NASTAD members, we acknowledged the impact the COVID-19 pandemic has had on health department activities at the state and local levels, reiterating our tremendous appreciation for their work to apply their infectious disease expertise to responding to the coronavirus while also innovating to ensure that vital HIV services remain available.
As I’ve done several times in recent months, I emphasized that HIV remains a priority for OIDP, the HHS Assistant Secretary for Health, and the current administration. We all remain committed to continuing EHE implementation in partnership with our local, state, and federal colleagues. We all must continue to be creative in finding safe ways to do our work and sharing our success stories to support and inspire each other.
EHE Stakeholders Webinar October 29
You can join us for our next EHE Stakeholders webinar on Thursday, October 29, 2020
from 2:00–3:30 PM (ET) to hear the latest updates on federal implementation activities and learn about models of community engagement in EHE planning at the jurisdiction level during COVID-19. yourself. The event is open to everyone, but capacity is limited. Register here.