Dear Colleague: July 27, 2021

July 27, 2021

Dear Colleague,

The Centers for Disease Control and Prevention (CDC) has awarded $117 million to state and local health departments to help rebuild and expand HIV prevention and treatment efforts as the United States recovers from COVID-19. The awards are part of the federal Ending the HIV Epidemic in the U.S. (EHE) initiative, which funds 57 priority areas to expand and tailor key HIV prevention strategies to community needs.

This is the second major round of CDC funding delivered to state and local health departments as part of the EHE initiative and builds upon initial investments awarded through CDC’s “Integrated HIV Program for Health Departments to Support Ending the HIV Epidemic in the United States” cooperative agreement (CDC-RFA-PS20-2010). Total awards range from $1.9 million to $10.6 million. Available funding was distributed based on the severity of the epidemic and the number of focus counties within each state. The awards will be used to reduce health disparities in collaboration with the four key strategies that, together, can end the HIV epidemic in the United States:

• Diagnose all individuals with HIV as early as possible after infection.
• Treat people with HIV rapidly and effectively to reach sustained viral suppression.
• Prevent new HIV transmissions by using proven interventions, including pre-exposure prophylaxis (PrEP) and syringe services programs (SSPs).
• Respond quickly to potential HIV outbreaks to get needed prevention and treatment services to people who need them.

As part of this investment, $11.1 million will be used to scale up quality HIV prevention services in sexually transmitted disease clinics in nineteen communities. In these settings, outreach will be expanded and strengthened to reach people at risk for HIV who may not otherwise have access to healthcare services.

Overall, CDC plans to distribute approximately $150 million of the FY 2021 EHE funding extramurally. This funding includes support for implementation of status neutral approaches to HIV prevention and care in transgender clinics, improving data, surveillance, monitoring, and evaluation activities, expanding reach of public and clinician communications campaigns, and increasing community engagement. These EHE investments will also expand syringe services programs.

Innovative, community-driven solutions are at the heart of EHE—and are already showing what is possible with expanded investment, collaboration, and locally tailored strategies. Recognizing the important role that community-based organizations (CBOs) have played and will continue to play in providing these and other critical HIV prevention and care services to people that have or are at risk for HIV, CDC requires that at least one-quarter of recipient funding go to activities implemented by CBOs. Additionally, CDC is planning to award an additional $9 million later this year to develop self-testing programs in at least 60 front-line CBOs and distribute self-test kits in these communities.

Importantly, EHE funding allows communities to provide services related to pre-exposure prophylaxis (PrEP) to people who could benefit from them. In addition to PrEP referrals and navigation, EHE funds can also be used to cover laboratory costs associated with PrEP provision in uninsured or underinsured people receiving PrEP. By providing testing and care services in more accessible, convenient ways, these innovations can better address long-standing barriers to prevention and care.

With continued investment and innovation, we have a once-in-a-generation opportunity to end the HIV epidemic. But to reach EHE goals, addressing disparities and moving toward health equity will be crucial.

Racial, ethnic, and geographic disparities have contributed to HIV prevention gaps for far too long. EHE helps address these disparities and facilitates health equity through a comprehensive approach that places resources where they are needed most and meets people where they are with the services they need. This approach helps mitigate the root causes that contribute to disparities such as systemic racism, homophobia, unequal access to health care, discrimination, poverty, limited education and employment opportunities, and stigma through policies, practices, and programs aimed at overcoming barriers to HIV prevention and care.

We recognize that our work has been made exponentially harder over the past year and a half, due to the impact of COVID-19 on the public health workforce and on the communities we serve. But even in the face of unimaginable challenges, the HIV prevention community has remained committed to reaching our shared goal. By expanding and sustaining the EHE initiative, in combination with a comprehensive, whole-person approach to care that places the person ahead of their HIV status, we can bring the HIV epidemic in the United States to an end once and for all.

Thank you for your continued resilience and commitment.

/Demetre Daskalakis/

Demetre Daskalakis, MD, MPH
Director
Division of HIV/AIDS Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/hiv

/Raul Romaguera/

Raul Romaguera, DMD, MPH
Acting Director
Division of STD Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/std

/Jonathan Mermin/

Jonathan H. Mermin, MD, MPH
Rear Admiral and Assistant Surgeon General, USPHS
Director
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Centers for Disease Control and Prevention
www.cdc.gov/nchhstp