Investment Areas

Through its information gathering efforts, DHP identified six areas where it can invest time and resources to further advance the four cross-cutting focus areas. By prioritizing these investment areas, the Division can promote health equity, expand community engagement, and promote the understanding and wide use of syndemic and status neutral approaches within its scientific and programmatic portfolio. These investment areas are meant to be additive and will not displace preexisting efforts or priorities. By investing in these areas, the Division will not only further its broad HIV prevention goals but also the goals of the EHE initiative.

The Division will strive to meaningfully invest in these areas to strengthen its operations and equip itself and its partners to deliver on DHP’s mission. Each investment area is comprised of a set of strategic actions that the Division will begin to implement in 2022 and will guide how it makes investments needed to reach national HIV prevention goals. While each investment area and the associated strategic actions are distinct, some of these actions may occur concurrently and some in phases.

Each investment area will have an impact on one or more of the cross-cutting focus areas previously outlined in this supplement (health equity, community engagement, syndemic approach and status neutral approach). The cross-cutting focus areas aligned to each investment area are marked in the detailed descriptions below for reference. To make the investment areas as action oriented as possible and help summarize potential levels of effort for carrying out activities, corresponding strategic actions are further categorized as new and/or enhanced resource investments, ways of doing business, or forms of engagement.

To best meet the demands of DHP’s programmatic/scientific portfolio and deliver on its mission, DHP aims to nurture and strengthen the well-being, diversity, and skills of its workforce to develop, support, and sustain its staff. By focusing on a more diverse, inclusive, and equitable workplace environment, DHP will equip its workforce with the skills, tools, and knowledge to support recipients and partners more effectively. To strengthen and nurture its workforce and operations, DHP will focus on the following strategies:

• Prioritize staff development and well-being and recruit and retain staff with lived and professional experiences that harmonize with the communities that DHP serves

• Enhance existing strategies, including internal feedback loops, and implement new strategies to prioritize well-being, including work/life balance in a hybrid work environment
• Develop a staff recruitment strategy that incorporates awareness days highlighted by CDC, thereby increasing staff recruitment efforts that support diversity, equity, and inclusion
• Develop a communication approach to share decisions, initiatives, changes, and business processes affecting the Division in a timely manner to ensure consistent messaging with grantees, partners, etc.
• Develop “communities of practice” across the Division for the EHE pillars and other HIV priority areas that include representatives within NCHHSTP/CDC and other federal agencies and partners
• Evaluate and strengthen how research translates to practice (e.g., existing touchpoints and communication channels) to develop, adopt, disseminate, and promote high-impact HIV prevention interventions and strategies

• Implement Moments that Matter approach to strengthen how DHP staff engage virtually and in person in a hybrid work environment
• Prioritize recruitment and retention activities to develop and maintain a diverse, equitable, healthy, and happy DHP workforce
• Provide more comprehensive training within DHP on health equity; effective community engagement; supporting the implementation of syndemic and status neutral approaches; trauma-informed care; well-being/self-care; and other important skills (e.g., informatics, data visualization) and prevention and treatment topics (e.g., criminalization, drug user health)

DHP aims to broaden how organizations and partners can access and use DHP funding to expand the impact of its work and to diversify the types of partners with which it works. In doing so, the Division hopes to increase engagement with and fund groups who historically have not been funded, such as organizations that are PLHIV/BIPOC-led. Additionally, the Division seeks to encourage innovations and a whole-person approach to care by expanding how funding can be used by recipients. To expand access to and use of DHP funding, DHP will focus on the following strategies:

• Increase transparency of funding to understand and optimize DHP funding allocations
• Explore alternative models such as microgrants and organizational development grants to provide funding and support to smaller grassroots organizations, minority-led organizations, and organizations led by persons with HIV
• Encourage and support health departments’ strategic use of microgrants to non-traditional organizations that are connected to and provide services to priority populations
• Create an innovation fund for DHP staff to propose, develop, and pilot innovative approaches

• Assess notice of funding opportunities (NOFOs) to identify potentially limiting language on allowable and unallowable activities (e.g., ancillary services, clinical care)
• Review NOFO template and modify language, where possible, to increase accessibility in the application process; encourage recipients, and maximize their flexibility, to incorporate SDOH indices to help jurisdictions better distribute resources; and employ equity tools that integrate racial/ethnic policies and programs
• Require health departments to allocate a percentage of awarded funding to support the development of nontraditional organizations
• Include supplemental application components to offer more avenues for applicants to demonstrate their capacity and pursue innovative approaches to meet the needs of their focus populations

• Expand considerations for organizational capacity to allow for a more diverse group of applicants, specifically to be more inclusive of organizations and groups that address SDOH but may not provide biomedical interventions
• Identify opportunity for groups that are not officially 501(c)(3) organizations to apply for smaller microgrants, like the HHS HIV Challenge Initiative

Recognizing the diverse needs of implementing partners, DHP aims to provide comprehensive and tailored support for all DHP funding recipients, pre- and post-award. The Division will work toward closing existing capacity gaps by increasing DHP’s support of organizational development. The Division will assess its existing guidance and technical assistance to not only make sure it is comprehensive, but that it is also up-to-date and accessible. To enhance implementation guidance and technical assistance, DHP will focus on the following strategies:

• Provide tailored support to new funding recipients and smaller organizations by funding larger, more established organizations to provide technical assistance, recognizing the unique challenges new and smaller organizations may face working with federal funding for the first time

• Develop materials, host webinars, and provide pretechnical assistance on how recipients can use federal funding, with a focus on braiding funding from different sources, and clarify allowable and unallowable comprehensive HIV prevention and care activities
• Identify best practices in implementation of status neutral and syndemic approaches to HIV prevention and care and share them with recipients and other partners
• Identify areas where recipients need additional technical assistance and where the Division can develop new or use existing guidance
• Review and update existing guidance with a digital-first approach to enhance usability and accessibility

• Expand channels to communicate new focus areas and NOFO requirements to reach those who are unable to engage via existing methods
• Use short-term details of DHP staff to health departments and CBOs to provide tailored technical and capacity building assistance

DHP aims to use and to promote data-informed approaches to prevention and care by facilitating access to accurate and comprehensive data, modernizing current data systems, and supporting data use among funding recipients. Implementing the syndemic and status neutral approaches and centering health equity necessitates the use of accurate data to determine optimal allocation of resources. To integrate data and data systems, DHP will focus on the following strategies:

• Engage in data modernization initiatives to support data systems improvement, increase transparency, and close gaps in data collection

• Use best practices and lessons learned from the COVID-19 response and associated health equity teams to improve demographic data standards
• Review existing data systems and generated data reports to identify where systems or reports can be consolidated or integrated across the division and used to inform program activities
• Increase the speed at which data is collected, analyzed, and shared using best practices learned from COVID-19, such as the use of presumptive data, to deliver more “real time” reports and progress assessments
• Create DHP dashboards that bring together surveillance, program, evaluation, and any other data for internal use and an externally facing dashboard to improve data transparency
• Develop webinars or trainings for internal and external audiences on “data and data systems 101” to increase knowledge, understanding, and use of existing data and data systems

• Collaborate with other NCHHSTP divisions, CDC Centers, and health equity teams to share data and develop data reports/economic models that support HIV prevention activities, including the implementation of syndemic and status neutral approaches
• Conduct research and collaborate with policy partners to develop a cost-benefit analysis on the effectiveness and benefits of syndemic and status neutral approaches and identify novel data visualization tools and analytics that better serve partner and recipient needs

DHP aims to diversify the scope of its partner engagements, expand collaborations, and foster a culture of cooperation. Additionally, DHP aims to cultivate a practice of knowledge sharing across the Division, its recipients, and its intra- and inter-agency partners. In doing so, the Division aims to expand its reach while also minimizing inefficiencies and duplicative efforts. To strengthen partnerships and increase collaboration, DHP will focus on the following strategies:

• Collaborate with federal partners on braiding funds and develop inter-agency agreements and guidelines of what is allowable

• Develop a learning collaborative to encourage group learning, offer direct assistance to support program delivery, and support resource management to promote knowledge sharing amongst DHP, its recipients, and partners
• Align efforts and identify areas for enhanced impact and innovation with other divisions, Centers, Institutes, and Offices (CIOs) and agencies addressing HIV-related issues, syndemic approaches, SDOH, or filling gaps that DHP cannot address to promote a comprehensive approach
• Develop a division-wide inventory of partnerships to have a clearer understanding of each partner and the rationale for the partnership
• Develop strategic partnerships with the private sector, including social media companies and social justice and health equity-oriented organizations, to extend the reach of our programs and leverage expertise and resources
• Increase accessibility to DHP’s research to promote evidence and data-informed approaches among DHP staff and recipients, contribute to the portfolio of research, and provide policy partners with evidence to support their work

• Collaborate with other federal agencies working in the HIV space to support alignment across objectives and maximize the impact of DHP-supported programs
• Discuss opportunities to streamline and harmonize NOFO reporting requirements across CDC and other agencies
• Develop opportunities for DHP staff and staff from other divisions within NCHHSTP, CDC more broadly, and key federal agencies to participate in a term-based detail program to improve relationships and promote knowledge sharing

DHP aims to provide the tools, resources, and trainings to build recipient and partner capacity to communicate essential information, share successes, and build trust. Strengthening partner communication capabilities will enable partners to better address messaging issues, such as stigma; promote HIV services; and better engage communities. To support partner and recipient communication efforts, DHP will focus on the following strategies:

• Improve knowledge and reach of communication resources by promoting DHP resources and developing the communication skills of the broader HIV workforce

• Highlight recipients and partners who effectively implement status neutral, syndemic, and innovative health equity approaches and strategies in their HIV prevention activities and promote other programmatic success stories using DHP’s communication channels
• Develop communication materials, strategies, and other tools that recipients and other partners can use to address inequities and stigma associated with HIV prevention and care services
• Showcase DHP’s communication resources at DHP Branch meetings, and other opportunities with sister NCHHSTP divisions, CIOs, and federal agencies

• Identify existing DHP communication resources available on the four focus areas and disseminate to recipients
• Coordinate across the Division to implement an effective and consistent partner engagement strategy
• Expand ambassador programs to further develop communication skills in the HIV workforce and extend the reach of DHP

Implementation

DHP will operationalize the strategic plan supplement through the development and implementation of frameworks and operational roadmaps. The Division will develop implementation frameworks for each of the focus areas that will help identify markers of success and associated activities and outputs to reach these markers.

Offices and branches will develop operational plans to identify the specific activities that they will support to successfully accomplish the priorities and strategic actions outlined within this document.

These tools will ensure the Division is making investments that will accelerate progress in reaching national HIV prevention and care goals over the course of the supplement period (2022–2025).