Ending the HIV Epidemic in the U.S. (EHE): Scaling Up HIV Prevention Services in STD Specialty Clinics
Overview
Through the EHE initiative, the Department of Health and Human Services (HHS) has set an ambitious goal of reducing all new HIV infections in the U.S. by 90% by 2030. To support this goal, HHS has provided multiple funding opportunities to jurisdictions.
- In 2019, CDC awarded supplemental funding to strengthen the infrastructure of STD clinics serving a high volume of racial/ethnic and sexual minorities to enhance and scale up HIV prevention services and build upon activities supported under PS19-1901: Strengthening STD Prevention and Control for Health Departments (STD PCHD).
- In January 2020, CDC continued support for scaling up HIV prevention services in STD specialty clinics with the announcement of the Notice of Funding Opportunity (NOFO): PS20-2010: Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States (EHE) to support the development and implementation of programs tailored to ending the HIV epidemic in America. This NOFO is made up of three components; Component C is focused on implementing strategies and activities that scale up HIV prevention services to reach populations that access care in STD clinics.
- In August 2020, a new investment from the Minority HIV/AIDS Fund (MHAF) aimed to specifically address under-resourced STD clinics. This investment leverages the current CDC-funded PS20-2004: National Network of Sexually Transmitted Diseases Clinical Prevention Training Centers (NNPTC) to bolster training and technical assistance efforts so STD specialty clinics can better provide HIV prevention services. Activities include providing onsite or distance-based (web or phone) consultations, guidance to conduct clinic assessments, in-person site visits, and resources.
Scaling Up HIV Prevention Services in STD Specialty Clinics
Component C funding is intended to strengthen the infrastructure of STD clinics, which serve a high volume of racial, ethnic, sexual and gender minorities. STD clinics play a vital role in the EHE initiative because:
- They serve populations who are not engaged in HIV prevention programs, or primary healthcare system for their STD and HIV prevention care;
- They serve as an important healthcare setting for patients who may not otherwise have access to healthcare services;
- STDs are associated with a higher risk of acquiring HIV and indicate increased risk of HIV acquisition in future and potential need for PrEP.
In the second year of Component C funding, recipients will again focus on implementing five strategies to scale up HIV prevention services to reach populations that receive and seek care in STD clinics.
- Assess or re-assess clinic infrastructure to document HIV prevention services, identify gaps, and assess service quality.
- Implement evidence-based approaches to scale up HIV prevention capacity in STD clinics, including self-collected STD testing, express visits, HIV testing and viral load assessment.
- Expand the capacity of STD clinics to offer pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and strengthen clinic and laboratory capacity for recommended follow-up visits for people on PrEP.
- Optimize linkage to, retention in, and re-engagement with HIV medical care.
- Facilitate partnerships with other community HIV clinical providers, health departments, and community-based organizations providing HIV prevention services and collaborating in the implementation of EHE.
Award Recipients
PS19-1901: Strengthening STD Prevention and Control for Health Departments Supplement
With the initial funds, three recipients were awarded a total of $1.3 million. The award period was September 16, 2019 to December 31, 2019. The three recipients were Baltimore City Health Department ($500,000), Georgia Department of Public Health (DeKalb County) ($300,000), and Louisiana Department of Health (East Baton Rough Parish) ($500,000).
PS20-2010: Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States Component C
Seven recipients were awarded a total of $3 million for the first year, which ran from August 1, 2020 through July 31, 2021. Nineteen recipients were awarded nearly $12 million for the second year, which began on August 1, 2021. This cooperative agreement is for five years of funding (August 1, 2020 to July 31, 2025), based on availability of funds.
In the second year of PS20-2010, a competitive supplement was announced. This supplemental funding is for a pilot project expanding field-based partner services that Disease Intervention Specialists (DIS) provide to contacts to increase access to and uptake of same-day HIV treatment, PrEP, and nPEP. In September 2021, three Component C recipients were awarded funding for the competitive supplement and received $250,000 each.
The seven recipients from year one:
- Alabama Department of Public Health (Jefferson County)
- Arizona Department of Health Services (Maricopa County)
- Baltimore City Health Department
- District of Columbia Department of Health
- San Francisco Department of Public Health
- City of Philadelphia Department of Public Health
- Missouri Department of Health and Senior Services (St. Louis County)*
The twelve additional recipients from year two:
- California Department of Public Health (Sacramento, San Diego, and Orange County)
- New York City Department of Health and Mental Hygiene
- Chicago Department of Public Health
- Florida Department of Health* (Hillsborough County)
- Georgia Department of Public Health (Fulton County)
- Houston Health Department
- Indiana State Department of Health (Marion County)
- Louisiana Department of Health (East Baton Rouge Parish)
- Maryland Department of Health (Montgomery and Prince George’s County)
- New Jersey Department of Health (Newark)*
- Ohio Department of Health (Columbus)
- Texas Department of State Health Services (Dallas County)
*The three competitive supplement recipients in year two:
- Missouri Department of Health and Senior Services (St. Louis County)
- Florida Department of Health (Miami-Dade County)
- New Jersey Department of Health (Newark)
PS20-2010 Recipient Award Amounts
| Recipients | PS20-2010 Recipients Year 2 Award Amount | *Supplement Award Amount |
|---|---|---|
| Alabama Department of Public Health / Jefferson County | $800,000 | |
| Arizona Department of Health Services / Maricopa County | $800,000 | |
| California Department of Public Health / Sacramento, San Diego, and Orange County | $800,000 | |
| Florida Department of Health / Hillsborough County (Miami-Dade County*) | $420,000 | $250,000 |
| Georgia Department of Public Health / Fulton County | $420,000 | |
| Indiana State Department of Health / Marion County | $525,000 | |
| Louisiana Department of Health / East Baton Rouge Parish | $525,000 | |
| Maryland Department of Health / Montgomery and Prince George’s County | $525,000 | |
| Missouri Department of Health and Senior Services / St Louis County* | $521,490 | $250,000 |
| New Jersey Department of Health / Newark* | $420,000 | $250,000 |
| Ohio Department of Health / Columbus | $420,000 | |
| Texas Department of State Health Services / Dallas County | $525,000 | |
| New York City Department of Health and Mental Hygiene | $782,929 | |
| Chicago Department of Public Health | $525,000 | |
| Houston Health Department | $525,000 | |
| Baltimore City Health Department | $800,000 | |
| District of Columbia Department of Health | $800,000 | |
| City of Philadelphia Department of Public Health | $795,581 | |
| San Francisco Department of Public Health | $800,000 |
PS20-2004: National Network of Sexually Transmitted Diseases Clinical Prevention Training Centers Supplement (Minority HIV/AIDS Fund)
The NNPTC training, technical assistance, and capacity building efforts launched in August 2020. Eight training centers and two national centers have been awarded a total of $3.9 million per year and are currently in their second year of work. This award is for three years based on availability of funds.
| Recipient | Award Amount |
|---|---|
| Columbia University (Training Center) | $370,000 |
| Denver Public Health (Training Center) | $370,000 |
| Johns Hopkins University (Training Center) | $370,000 |
| Massachusetts Department of Public Health (Training Center) | $370,000 |
| University of Alabama (Training Center) | $370,000 |
| University of California, San Francisco (Training Center) | $370,000 |
| University of Washington (Training Center) | $370,000 |
| Washington University, St. Louis (Training Center) | $370,000 |
| The National STD Prevention Training Centers Coordination Center (NPTC3) – Denver Public Health | $312,500 |
| National STD Curriculum Center – University of Washington | $625,000 |
Resources
- Infographic – Reversing the Rise in STIs: Integrating Services to Address the Syndemic of STIs, HIV, Substance Use, and Viral Hepatitis (June 1, 2022)
- Dear Colleague Letter from the Division of STD Prevention: CDC Awards $11.1 Million for HIV Prevention Services in STD Clinics
- Dear Colleague Letter from the Division of HIV Prevention: Advancing the Ending the HIV Epidemic Initiative in the U.S. with a $117 Million Investment
- CDC’s Ending the HIV Epidemic website
- America’s HIV Epidemic Analysis Dashboard (AHEAD)
- Funding Opportunity Announcement PS20-2010: Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States