White House Roundtable on Housing and Sexual Health

Content From: Robyn Neblett Fanfair, MD, MPH, Captain, USPHS, Acting Director, Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and PreventionPublished: August 23, 20233 min read


Leandro Mena, MD, Director, Division of STD Prevention, CDC; CAPT Robyn Neblett Fanfair, MD, Acting Director, Division of HIV Prevention, CDC; and Harold Phillips, Director, Office of National AIDS Policy, The White House

In May, I was honored to attend the White House Roundtable on Housing and Sexual Health. Housing stability is a fundamental determinant of health with far-reaching effects on HIV and STD prevention and health outcomes. Despite having finite resources and competing priorities, municipalities, and community-based organizations (CBOs) continue to create innovative programs that address the intersection of housing and sexual health.

The meeting began with three excellent and engaging speakers. Executive Director of the National HIV/AIDS Housing Coalition, Lauren Banks, gave an overview of the housing needs landscape and summarized the evidence for housing instability’s contribution to HIV and hepatitis C incidence. David Kern, Deputy Commissioner of the Syndemic Infectious Disease Bureau at the Chicago Department of Public Health, shared how the City of Chicago incorporates housing into its HIV and syndemic disease programming. Lastly, the Executive Director of Us Helping Us, People Into Living Inc., Dr. DeMarc Hickson, demonstrated the wide range of activities involved in syndemic disease prevention and treatment and the complex financing streams the organization must tap into to conduct those activities.

After the three presentations, roundtable attendees discussed how federal agencies can better support innovative work in communities nationwide. Harold Phillips, Director of the White House Office of National AIDS Policy, hosted the meeting and we were joined by federal colleagues from CDC’s Division of HIV Prevention and Division of STD Prevention, the Office of Infectious Disease and HIV/AIDS Policy at HHS, HRSA’s HIV/AIDS Bureau, and the Department of Housing and Urban Development. From the experiences and opinions that attendees shared, three themes emerged from the discussions and presentations: the need for diverse funding streams, sexual health and housing wraparound services, and how to expand cross-sector partnerships.

Whole-person approaches to disease prevention require diverse funding streams because disease-specific funding is often too restrictive. Programs focused on social determinants of health (SDOH) and equity interventions can address a broader range of health and other needs. Federal programs must coordinate more closely across agencies and use technical assistance, capacity building, and communication to clarify where program funding streams can and cannot coincide.

For sexual health and housing wraparound services, federal, state, and local organizations should explore ways to create a resource hub with access to health and housing services supported by healthcare, housing, and public health prevention funding sources. Removing legal and policy barriers to services (e.g., income requirements, drug abstinence requirements, or discrimination against people engaged in sex work) would dramatically increase access and effectiveness of wraparound services.

Community-based organizations and local health departments’ capacity to apply for funding is often scarce. Single or modular “one-stop” applications for multiple funding streams could lessen the organizational burden of improving partnerships between federal agencies like HUD, HRSA, and CDC.

The meeting concluded with an agreement to increase federal collaborations between agencies to address restrictive eligibility criteria for SDOH issues. CDC is committed to continuing to examine methods to promote the practice of braided funding to reduce the financial and grant writing burden on local service providers.

Thank you to the planners and contributors for this fruitful conversation. I'm so proud to be a part of one of the agencies that continues to move this critical work forward. Working together —federal, state, and local— we can better achieve all our missions and make our communities healthier.