[David C. Harvey, Washington, DC, 8/27/18]

On behalf of NCSD’s board, staff and our state, city and territorial STD public health members, I welcome you to the National STD Prevention Conference and my hometown of Washington, D.C.

Our conference theme is intersecting epidemics, integrated solutions and shortly we will hear from our colleague, Demetri, about ways to harmonize the HIV and STD response.

I like using the term harmonizing and I also like using the word “syndemic” epidemics – because these multiple epidemics are truly interconnected and cannot be addressed in isolation. Harmonizing STD and HIV prevention — and while we are at it, harmonizing with substance abuse, opioids, and other areas — to build a comprehensive sexual health network of programs and services, is what is needed.  This isn’t bringing together two or more different entities, its recognizing and capitalizing on the fact that these diseases and sectors are inextricably linked.

I want to address the elephant in the room. Let’s not shy away from the most difficult aspects of collaboration within our field. For a long time, there has been debate and conflict between the STD and HIV sectors.  Some are calling for the “desiloing” of funding streams, as was discussed at this year’s  International AIDS conference.  Some fear that HIV is going to “take over” STDs. I don’t share those fears and I think Congress has something to say about this, by the way. I don’t argue for desiloing but I do argue for harmonizing and collaboration and resource sharing. The STD field can and must lead now more than ever before. Our history, expertise, values, and approach are desperately needed by the HIV community and other sectors and we must rise to the challenge of what are probably the highest numbers of STIs in our history. In short, we must lead and we must lead in new and different ways.

And while I am at it. Another point about HIV.

Some in the HIV community don’t like hearing this – but the biological and behavioral factors fueling STDs and HIV firmly tie us together. HIV is an STD.  Let me be clear, STDs are not the cost of doing business in an era of PrEP, LARCs and biomedical prevention, as some have suggested. These tools present us with stark opportunities, whether it be to collaborate with HIV on PrEP and STD screening, or turning to other areas like maternal and child health to end congenital syphilis, working with reproductive health and family planning to fight PID and cervical cancer.  These collaborations are not a “one-way” or “uni-directional” conversation about how STDs can help other sectors, it is a two-way and bi-directional conversation, particularly with

the HIV community, who sometimes has approached this as a one-way street. That needs to change.

As HIV becomes more preventable and a chronic disease, its more and more like other STDs requiring a specialized population-based approached to serving those most at-risk and impacted. We must ensure that robust, effective STD screening, treatment and partner services are in place for people living with HIV and those on PrEP, and for this, our field needs more money to provide these services – either through increased funding from Congress and states or more HIV dollars given to the STD field for this purpose. No more HIV dollars being handed back to the U.S. Treasury because they can’t be spent – spend these dollars on STD services and harmonize the response.

NCSD is working in new and innovative ways to bring visibility to our field in the media, to sing about the successes of public health programs, to lift-up the voices of STD clinics and clinical researchers, and to win battles in Congress. We are living a new vision for the future of our field – and all of this despite funding cutbacks over the last 18 years. All you have to do is look at examples like Los Angeles County’s “don’t think know” social media campaign, Rhode Island’s geo-fencing project, Washington state’s efforts to rethink partner services and DIS in the digital age, Vermont’s response to the opioid and STD crisis, and South Carolina’s efforts to utilize adolescent school health programs to train DIS on how to work with youth.  And I could go on and on and on with examples of innovation. In addition to promoting innovation, we will be promoting administrative simplification – eliminating outdated rules, creating flexibility in funding streams so that local communities can respond in a way that they know best, and address how to pay for services. How’s that for harmonization?

Join us!  Become an associate member of NCSD for free.  Attend STD Engage 2018 in Orlando in November, sign up for Voter Voice. Request technical assistance from our superb program team at NCSD. Visit our conference booth here to learn more.

As Abraham Lincoln said: “determine that the thing can and shall be done, then we shall find the way.”

Joycelyn Elder, perhaps, gave one of the ultimate quotes about harmonizing our field: “health is more than absence of disease; it is about economics, education, environment, empowerment and community. We must provide the best possible health [options] with the least disparities and respond equally well to everyone.