During his State of the Union address on Tuesday, the President announced a plan to end the HIV epidemic. The Department of Health and Human Services (HHS) released documents detailing the plan, Ending the HIV Epidemic: A Plan for America, which aims to reduce new HIV infections by 75% in the next five years and by 90% in the next ten years. Leadership at CDC, NIH, HRSA, Indian Health Services, and HHS penned an editorial in the Journal of the American Medical Association on Wednesday outlining plans for coordination across several federal agencies.

Important to note is that there has been no mention of syndemic STDs in the plan. NCSD released this statement and is working hard ensure that the STD field is represented in this plan.

NCSD participated in several in-person meetings throughout the week with senior HHS officials and will continue to engage with the administration to ensure that STDs, a driver of many new HIV infections, are addressed in this plan. Due to NCSD efforts and a question posed by NCSD’s David C. Harvey during an address to the American Public Health Association on Wednesday, ADM Brett P. Giroir, M.D., Assistant Secretary for Health, did recognize that these epidemics are interrelated and that STDs have impacts on HIV transmission.

Overview of the Ending the HIV Epidemic Plan

The plan targets 48 high-morbidity counties across the nation that account for 50% of the HIV morbidity. It is expected these counties will be directly funded and that states in which those counties lie will be eligible for supplemental funding opportunities.

Below is HHS’s five-pronged strategy to end the HIV epidemic. There are potential areas where these plans can and should intersect with the STD field.

• HIV HealthForce – A boots-on-the-ground workforce of culturally competent and committed public health professionals that will carry out HIV elimination efforts in HIV hot spots.
• Treat – Implement programs to increase adherence to HIV medication, help people get back into HIV medical care and research innovative products that will make it easier for patients to access HIV medication.
• Diagnose – Implement routine testing during key healthcare encounters and increase access to and options for HIV testing.
• Protect – Implement extensive provider training, patient awareness and efforts to expand access to PrEP.
• Respond – Ensure that states and communities have the technological and personnel resources to investigate all related HIV cases to stop chains of transmission.

Funding

There has been word that this plan will entail a significant amount of new funding across multiple agencies and that the funding will not be reallocated from current HIV funding.

The latest speculated dollar figures are a $130 million increase to CDC to implement aspects of the plan. Other agencies included in this announcement include HRSA, HIS, NIH, SAMHSA, and OASH.  It is expected that this funding will be officially announced through President Trump’s budget request expected in mid-march. It is unclear how much, if any of these funds will be allocated to fund direct STD services, and it is unclear whether Congress will support the broader Ending the HIV Epidemic initiative.

The plan will fund three major areas of action:

1. Increasing investments in geographic hotspots through our existing, effective programs, such as the Ryan White HIV/AIDS Program, as well as a new program through community health centers that will provide medicine to protect persons at highest risk from getting HIV.
2. Using data to identify where HIV is spreading most rapidly and guide decision-making to address prevention, care and treatment needs at the local level.
3. Providing funds for the creation of a local HIV HealthForce in these targeted areas to expand HIV prevention and treatment.