CDC’s Role in Implementing the
National HIV/AIDS Strategy
Kevin Fenton, M.D., Ph.D., F.F.P.H.
Director
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
December 14, 2010
HIV Prevention Leadership Summit
Vision of the
National HIV/AIDS Strategy
“The United States will become a place where new HIV
infections are rare and when they do occur, every
person, regardless of age, gender, race/ethnicity,
sexual orientation, gender identity or socio-economic
circumstance, will have unfettered access to high
quality, life-extending care, free from stigma and
discrimination”
The National HIV/AIDS Strategy
Goals:
1.
2.
3.
4.
Reduce HIV incidence
Increase access to care for
people living with HIV and
optimize health outcomes
Reduce HIV-related
disparities
Improving coordination
National AIDS Strategy Supports CDC
strategic vision of a tiered approach to
prevention
Prevention with
HIV positive
individuals
HIV Rx and Care,
PN, Counseling,
STD Rx, SSP
Prevention with high
risk HIV negatives
Intensive, targeted community
level interventions (geography,
ethnicity etc)
General population interventions
HIV Screening,
treatment,
DEBIs, STD Rx,
Combination
prevention, SDH,
DEBIs,
Social marketing,
HIV screening,
stigma
Key Principles for CDC Priority Activities in
support of the NHAS
• Ensure strategic alignment of budget, programs and
policy with the NHAS
• Focus on evidence-based, high impact activities with
potential for scaling up interventions
• Support innovation with evaluation and research
• Leverage assets of the entire agency – not just DHAP
• Seek opportunities for collaboration and integration to
address HIV and associated syndemics
• Maximize novel interagency collaborations to reduce
duplication and missed opportunties
Goals of the
NATIONAL HIV/AIDS STRATEGY
Interagency Coordination
Strengthening Collaborations with other federal agencies
• Assisted Office of National AIDS Policy (ONAP) in
development of NHAS
• Continues to coordinate and collaborate with ONAP
– CDC participated in White House meeting on implementing the
NHAS in the Latino community
• Working with Assistant Secretary of Health at HHS for HIV
prevention, PrEP, Hepatitis Coordination
• Ensuring the DHAP, DVH and DSTDP strategic plans being
finalized aligns with the NHAS
• Assigned specific tasks in the NHAS Implementation Plan
Interagency Coordination
Novel partnerships with other Federal agencies
• CDC participating in federal workgroups established to
implement and monitor the NHAS
• CDC working with other HHS agencies in implementing the
“Enhanced Comprehensive HIV Prevention Planning and
Implementation Program for state and local health
departments”
• CDC and NIH collaborating to develop research opportunities
• HRSA and CDC to identify community health centers that
provide “co-located” HIV testing and care and treatment
services.
Interagency Coordination
Promoting Program Collaboration and Service Integration
• PCSI aims to promote more coordinated, holistic and
syndemic orientation of NCHHSTP prevention activities
• In September 2010, awards made to six health
departments for new FOA, “Addressing Syndemics through
PCSI”
– Recipient jurisdictions are: New York City, North Carolina,
Philadelphia, San Francisco, Texas, Washington, D.C.
– $6.2 million over 3 years for the PCSI program
• Will be used to combine and streamline health services for
HIV/AIDS, STDs, viral hepatitis, and tuberculosis; identify
best practices; and build evidence base for integration
Reduce HIV Incidence
Enhanced Comprehensive HIV Prevention Program
• Comprehensive Prevention Program for State and Local
Health Departments funds demonstration projects for a
combination approach to enhance effective HIV prevention
– Intensifying prevention for people at greatest risk
– Prioritizing prevention and linkage to care for people living with HIV
– Directing funding to communities with highest burden of HIV
• Grants totaling $11.6 million awarded in FY 2010 to 12 hard-hit
areas
−
Chicago, District of Columbia, Florida, Georgia, Houston, Los
Angeles, Maryland, New York city, Philadelphia, Puerto Rico, San
Francisco, and Texas
Reduce HIV Incidence
Expanded HIV Testing Program
• Originally aimed primarily at African Americans, HIV Testing
Initiative was expanded in FY 2010 to reach gay and bisexual
men of all races, injection drug users of all races, and Hispanic
populations, as well as African Americans
• Accomplishments to date
• More than 1.4 million people have been tested through CDC’s HIV
Testing Initiative
• <10,000 have been newly diagnosed with HIV
• Majority have been linked to care
• Of new positives, 86 percent received their results, 75 percent
were linked to medical care, and 78 percent were linked to partner
services.
• Awarded about $55 million in FY 2010 for first year of 3-year
expanded program
Reduce HIV Incidence
Other CDC Commitments
• Strengthen community-based investments
– Align Community Based Organization (CBO) activities to NHAS
– Critically reexamine Community Planning
• Strengthen focus on highest incidence groups
– HIV Prevention projects for CBOs and Young MSM of Color and
Young Transgender Persons of Color
– Strengthen STD screening efforts with a focus on STIs among MSM
– Expand screening and mobilization with African Americans, Latinos
• Work with States to improve program, surveillance, M&E
– Funding to 65 health departments for HIV prevention in FY12
– Ongoing reporting of data on HIV incidence in the US as well as
new surveillance methods to track CD4 and Community Viral Load
Increase Access to Care
CBO Program FY 2010 Awards
• Program provides funds for CBOs to implement effective
HIV prevention efforts among populations at highest risk
– Includes increase in linkage to care as a goal
– $42 million awarded in FY 2010 to 133 community-based
organizations
• Program funds were awarded to match the epidemic
– 49 percent of organizations receiving funds focus efforts on MSM,
while 38 percent focus on heterosexual men and women
– 5 percent of CBOs focus on injection drug users
– 58 percent of CBOs focus on African Americans, while 23 percent
focus on Latinos, 11 percent on whites, 3 percent on Asian/Pacific
Islanders and 1 percent on Native Americans.
Increase Access to Care
Other CDC Commitments/Activities
• Enhanced Comprehensive HIV Prevention Planning
and Implementation Program for state and local health
departments
– Includes prioritizing linkage to care for people living with HIV
• CDC working with Health Resources and Services
Administration (HRSA) to support a six-clinic, multiyear evaluation of interventions to increase HIVpositive clients’ attendance of appointments.
Reduce HIV-related Disparities:
Expanded Act Against AIDS Leadership Initiative
• A $16 Million, 6-year partnership between CDC and 19
of the nation’s leading AA and Latino organizations to
integrate HIV prevention into their activities for African
Americans, Latinos, and gay and bisexual men
• Examples of key activities include
–
–
–
–
–
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Holding educational and training sessions
Integrating prevention messages into community forums
Placing PSAs in broadcast and print outlets
Working with celebrities to produce PSAs
Mobilizing local policymakers and community leaders
Extending campaigns through internet, social media ,etc.
Reduce HIV-related Disparities:
HIV Prevention Projects for CBOs and Young MSM of Color and Young
Transgender Persons of Color
• Program provides effective HIV prevention services to
young (up to age 22) MSM of color and young (up to
age 24) transgender persons of color who are at high
risk for HIV infection or transmission
• Major activities have included implementation of
effective behavioral interventions and comprehensive
risk counseling and services or counseling, testing and
referral services
Reduce HIV-related Disparities:
Enhanced Surveillance
• Enhanced HIV surveillance: Community viral
load and CD4 monitoring
– Funds awarded in FY 2010 to support additional
data needs for community HIV viral load
monitoring
– CDC exploring how community viral load could be
monitored nationally
• Publication in FY 2010 of estimate of impact of
HIV and syphilis on gay and bisexual men
• Publication of white paper on social
determinants of health:
– Establishing a Holistic Framework to Reduce
Inequities in HIV, Viral Hepatitis, STDs, and
Tuberculosis in the United States
Vision of the
National HIV/AIDS Strategy
“The United States will become a place where new HIV
infections are rare and when they do occur, every
person, regardless of age, gender, race/ethnicity,
sexual orientation, gender identity or socio-economic
circumstance, will have unfettered access to high
quality, life-extending care, free from stigma and
discrimination”
Thank you!
Kevin A. Fenton, M.D. Ph.D., F.F.P.H.
National Center for HIV/AIDS, Viral Hepatitis, STD and
TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov