At-A-Glance: For Partners and Stakeholders

Although the Ending the HIV Epidemicexternal icon initiative is slated to begin in 2020, planning is now underway. PS19-1906: Strategic Partnerships and Planning to Support Ending the HIV Epidemic in the United States is structured in two components.

Component A: National Level Strategic Partnerships, Communication, Policy Analysis, and Interpretation

Under Component A of PS19-1906, National Alliance of State and Territorial AIDS Directors (NASTAD) has been awarded $1.5 million per year from 2019 to 2024, based on the availability of resources, to enhance local health departments’ capacity to end the epidemic. NASTAD will focus on providing support for the 57 jurisdictions that have been prioritized for the first year of the initiative.

This capacity-building effort also supports the development and maintenance of strategic communication channels and partnerships that advance national HIV prevention goals and contribute to Ending the HIV Epidemic efforts.

Component A also supports important policy efforts, including:

• policy analysis and interpretation (e.g., tracking state and local activity on policies and laws relevant to HIV programs);
• developing policy-related educational products to state health departments and national policy stakeholders;
• analyzing and interpreting national and jurisdictional-level data in areas of HIV prevention and surveillance policies and programs; and
• providing support and technical assistance to health departments on ways to effectively communicate with and educate policymakers about their HIV prevention, surveillance, and treatment programs.

Component B: Accelerating State and Local HIV Planning

Under Component B, $12 million of the HHS Minority HIV/AIDS Fund has been awarded to 32 CDC-funded state and local health departments to develop comprehensive Ending the HIV Epidemic plans that are tailored by and for each community.

Community engagement is paramount to the success of these plans. This funding opportunity will support jurisdictions to engage their local communities, HIV planning bodies, HIV prevention and care providers, and other partners in an accelerated and collaborative process to develop plans that address the four national Ending the HIV Epidemic strategies.  This approach will also provide flexibility to address local challenges that vary from one community to another. These plans will lay the groundwork for rapid implementation of Ending the HIV Epidemicstrategies beginning in 2020, pending Congressional appropriation of EHE initiative funding.

State and Local HIV Planning Components

• Engage with existing local prevention and care integrated planning bodies that have experience representing local populations and stakeholders about the best HIV prevention and care strategies. These collaborative efforts should include working with HRSA-funded Ryan White Part A and B recipients.
• Engage diverse community perspectives – including new partners who have not traditionally been at the planning table.
• Prepare a current epidemiologic profile to provide a comprehensive overview of the local HIV epidemic, which can be shared with local planning bodies and partners.
• Prepare a brief situation analysis that provides an overview of strengths, challenges, and needs related to key aspects of HIV prevention and care activities within the jurisdiction.
• Involve people with HIV and members of local communities most heavily impacted by HIV in the planning process, which is crucial to ensure programmatic activities are conducted in ways that are acceptable to and adopted by affected local populations.
• Engage with local HIV service providers who deliver prevention, care, and other essential services for people with HIV. This engagement is critical for developing a feasible and sustainable plan that can accommodate the increasing number of individuals who will be seeking these services.
• Reach agreement on the new or updated Ending the HIV Epidemic plan with local planning groups.
• Prepare a final Ending the HIV Epidemic plan for the jurisdiction that describes the specific strategies that will be employed locally to achieve the objectives outlined in the initiative. This document will be used to guide future funding for programmatic activities. While draft plans are due to CDC by December 30, 2019, the plans are expected to evolve, and be refined over the project period.

Community Engagement and CDC Guidance

Community input has always been critical to HIV prevention and has shaped the development of Ending the HIV Epidemic in many important ways. Federal agencies have sought input from leaders at multiple levels on the national framework — and on steps for moving it forward — during national conferences; webinars; meetings with national organizations; site visits with communities across the country; and ongoing engagement with CDC-funded partners and organizations.

Based on this input, CDC has been working to ensure several key elements are integrated into next steps and implementation planning.

• Flexibility:  While the EHE program planning guidance outlines core strategies and outcomes that must be addressed across all areas, jurisdictions will have greater flexibility to design and propose new approaches to meeting local needs.
• Hearing new voices:  As they develop local EHE plans, state and local health departments will be expected to engage diverse community perspectives – including new partners who have not traditionally been at the planning table.
• Innovation: Under the EHE initiative, health departments are encouraged to pursue bold, new ways of approaching HIV prevention and overcoming existing barriers to HIV prevention, testing, and treatment.
• Building upon community experience already in the field:  Best practices have been elicited from experienced state and local partners already working in the field in each jurisdiction. These findings will be shared broadly to ensure others can effectively identify, replicate, or adapt those approaches to their own communities.

CDC is in the process of issuing additional guidance to ensure robust and diverse community involvement in development of local plans, which will continue to be refined over time, by the community. Program guidance will include, but is not limited to, providing additional recommendations on:

• • The community engagement process
  • Situational analyses;
  • Plan organization; and
  • Planning scenarios.

• The community engagement process will involve the collaboration of key stakeholders and broad communities working together to identify strategies for increased coordination of HIV programs throughout the state, local health jurisdictions, or tribal areas. This collaboration will result in a collective vision that assists the jurisdiction in achieving the goals of the EHE initiative.
• In creating their EPI profiles, recipients will use the most current local data available to create a comprehensive snapshot of the local HIV epidemic. The goal of the snapshot approach is to serve the same purpose as a full epidemiologic profile, but in a format that is much less burdensome to the funded jurisdictions.
• Recipients will also submit a snapshot summary of a current situational analysis. The analysis will provide an overview of strengths, challenges, and identified needs. It will synthesize information from the local epidemiologic profile, from the engagement with local planning bodies, and from other local partners and local community engagement efforts.
  • Social determinants of health relevant to HIV prevention (e.g., housing instability, food insecurity, transportation, homophobia, transphobia, racism) will be considered in the planning activities. When engaging with partners and considering the local situational analysis, grantees are advised to explore strategies that may be able to address or mitigate these factors as they relate to barriers to effective HIV prevention and care efforts.
• Health departments will engage local partners in an accelerated and collaborative planning process to develop EHE plans tailored for the local jurisdictions. This collaborative planning process will allow health departments to address local needs and provide flexibility to address local challenges that vary from one community to another, consistent with the HIV integrated planning process. The plans will be organized by EHE pillars: Diagnose, Treat, Prevent, and Respond. For each pillar, jurisdictions will describe anticipated HIV workforce needs.
• If funded, Ending the HIV Epidemic implementation will begin in 2020.