Scaling Up HIV Prevention Services in Sexual Health Clinics

Scaling up HIV Prevention Services in Sexual Health Clinics

Through the Ending the HIV Epidemic (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, including continued investments in sexual health clinics.

In January 2020, CDC announced the Notice of Funding Opportunity (NOFO): PS20-2010: Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in the United States to support the development and implementation of programs tailored to ending the HIV epidemic in America.

Component C of this NOFO focuses on implementing strategies and activities that scale up HIV prevention services to reach populations that access care in sexual health clinics. This funding aims to strengthen the infrastructure of sexual health clinics, which serve a high volume of people from racial, ethnic, sexual and gender minority groups. Sexual health 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 STI and HIV prevention care
• They serve as an important healthcare setting for patients who may not otherwise have access to healthcare services
• STIs are associated with a higher risk of acquiring HIV and indicate increased risk of HIV acquisition in future and potential need for pre-exposure prophylaxis (PrEP)

PS20-2010 Component C Strategies

With Component C funding, recipients focus on implementing five strategies to scale up HIV prevention services to reach populations that receive and seek care in sexual health clinics.

1. Assess or re-assess clinic infrastructure to document HIV prevention services, identify gaps, and assess service quality.
2. Implement evidence-based approaches to scale up HIV prevention capacity in sexual health clinics, including self-collected STI testing, express visits, HIV testing and viral load assessment.
3. Expand the capacity of sexual health clinics to offer PrEP, post-exposure prophylaxis (PEP), and strengthen clinic and laboratory capacity for recommended follow-up visits for people on PrEP.
4. Optimize linkage to, retention in, and re-engagement with HIV medical care.
5. 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

Seven recipients were awarded a total of $3 million for the first year (August 1, 2020 – July 31, 2021). Nineteen recipients were awarded nearly $12 million for the second year (August 1, 2021 – July 31, 2022), nearly $14 million for the third year (August 1, 2022 – July 31, 2023) and approximately $11.6 million for an abbreviated final year (August 1, 2023 – May 31, 2024).

In the final 10 months of the project, thirteen recipients (shown in green on the map) also received a total of $3.4 million in supplemental funding to support the integration of mpox services into routine sexual health care at participating clinics.

Addressing Under-Resourced Sexual Health Clinics with the Minority HIV/AIDS Fund

In August 2020, a new investment from the Minority HIV/AIDS Fund (MHAF) aimed to specifically address under-resourced sexual health clinics. This investment leverages the current CDC-funded National Network of Sexually Transmitted Diseases Clinical Prevention Training Centers (NNPTC) to bolster training and technical assistance efforts so sexual health 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.

Award Recipients

Eight training centers and two national centers have been awarded a total of $3.9 million per year and are currently in their fourth year of supplemental MHAF funding.

Resources

• Infographic – Reversing the Rise in STIs: Integrating Services to Address the Syndemic of STIs, HIV, Substance Use, and Viral Hepatitis
• 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