On September 8, The Centers for Disease Control and Prevention announced that they will lead new programs totaling more than $185 million in HIV prevention funding for men who have sex with men (MSM) and transgender people, with a particular focus on addressing the needs of MSM of color. The multi-faceted strategy will respond to the severe burden of HIV among MSM and transgender men and women through three new programs enabling health departments and local HIV prevention partners to deliver the most effective HIV prevention tools.
"We have more powerful HIV prevention tools than ever before. Now, we need to get them into the hands of the people who need them the most," said Jonathan Mermin, M.D., M.P.H., director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
CDC is awarding up to $125 million over three years to state and local health departments to expand the use of two new, vital prevention strategies: pre-exposure prophylaxis (PrEP) for MSM and transgender people who are HIV-negative but at substantial risk, and ongoing medical care and antiretroviral treatment for people living with HIV.
An additional investment of up to $60.5 million over four years from the Department of Health and Human Services Secretary's Minority AIDS Initiative Fund (SMAIF), which supports innovative approaches to addressing HIV in minority communities, will help intensify prevention efforts specifically for MSM of color.
Despite comprising only about two percent of the U.S. population, MSM account for more than half of the estimated 1.2 million people living with HIV in this country. Additionally, the most recent CDC data show increases in both HIV incidence and diagnoses among MSM, with stark increases among young MSM of color. MSM now account for almost 70 percent of all new HIV diagnoses, and MSM of color account for nearly two-thirds of diagnoses among MSM.
Accelerating PrEP and Engaging More People in Care
Up to $125 million of the funding will be provided over three years to state and local health departments to scale up two new, powerful HIV prevention strategies:
• Increasing PrEP uptake: Numerous studies have shown that people who take PrEP daily can reduce their risk of contracting HIV by more than 90 percent.
o Health departments will be funded to provide PrEP information and referrals and to conduct outreach and training to increase the number of health care providers who are knowledgeable about PrEP and offer it to their patients.
o The primary objective is to increase the knowledge about and uptake of PrEP among MSM and transgender people at greatest risk of infection.
o Twenty-four health departments in areas where MSM are severely impacted are eligible to apply for these funds.
• Using routinely collected data to increase engagement in HIV care: A recent CDC study showed that more than 90 percent of new HIV infections in the U.S. could be averted by diagnosing people living with HIV and ensuring they receive prompt, ongoing care and treatment. Only about half of MSM diagnosed with HIV in the U.S. are engaged in regular care.
o Health departments will be funded to expand the use of HIV surveillance data to help connect and reengage people diagnosed with HIV but not in care with needed services, prioritizing MSM and transgender people.
o Twelve health departments in areas where MSM are severely impacted and that have sufficient clinical data are eligible to apply for these funds.
"Science tells us that increasing PrEP access and engaging more HIV-positive people in care and treatment could prevent tens of thousands of new HIV infections, but these strategies remain underused," said Eugene McCray, M.D., director of CDC's Division of HIV/AIDS Prevention. "This new funding will drive wider adoption where it's urgently needed and provide lessons on how to improve uptake nationwide."
HIV Prevention and Care for MSM of Color
To bolster these efforts in areas where MSM of color are especially hard hit, CDC will also coordinate innovative, multi-agency demonstration projects designed to comprehensively address the unique HIV prevention and care needs of MSM of color. Through SMAIF, funding of up to $60.5 million will be awarded over four years to support state and local health departments in the development of collaborative service networks.
These networks may include local community-based organizations, clinics and providers of HIV prevention and care, mental health services, substance abuse treatment, and critical social supports including housing and employment services. The programs will provide a broad package of early diagnosis, prevention and care services and actively address these critical social determinants required to keep MSM of color healthy. Twenty-eight state and local health departments representing communities with severe epidemics among MSM of color are eligible to apply.
To help ensure the success of these demonstration projects, one additional $5.5 million award will fund a national organization to support training and technical assistance for these programs. Assistance will focus on a number of critical areas, including enhancing cultural competency among staff and strengthening skills in helping clients navigate prevention and care services using peer-based or other proven approaches.
"By harnessing the power of recent scientific breakthroughs, we can change the course of the epidemic among MSM and transgender people, who continue to face the highest risk for infection in this country," said Merman.
Accelerating PrEP uptake and engaging more people in HIV care.
Up to $125 million of the funding will be provided over three years to state and local health departments to:
Increase uptake of HIV pre-exposure prophylaxis (this is called category 1 in the list below and is referenced in the release linked above in the first main bullet under Accelerating PrEP uptake and engaging more people in HIV care); and
Engage more people in HIV care (this is called category 2 in the list below and is referenced in the release linked above in the second main bullet under Accelerating PrEP uptake and engaging more people in HIV care).
The health departments funded for these activities are:
San Francisco Department of Health (funded for both Cat 1 & 2)
Chicago Department of Health (funded for both Cat 1 & 2)
Louisiana Department of Health (funded for both Cat 1 & 2)
Baltimore Department of Health (funded for Cat 1)
Virginia State Department of Health (funded for Cat 1)
Tennessee State Department of Health (funded for Cat 1)
Houston Department of Health & Human Services (funded for both Cat 1 & 2)
California Department of Health (funded for Cat 1)
Michigan Department of Community Health (funded for Cat 1)
New York City Department of Health & Mental Hygiene (funded for Cat 1)
Colorado Department of Health (funded for Cat 1)
Los Angeles County Public Health Department (funded for Cat 1)
Developing Comprehensive Models of HIV Prevention and Care for MSM of Color
An additional investment of up to $60.5 million over four years from the Department of Health and Human Services Secretary's Minority AIDS Initiative Fund (SMAIF) will help intensify prevention efforts specifically for gay and bisexual men of color.
The health departments funded under that piece of the effort are:
New York City Department of Health & Mental Hygiene
Baltimore Department of Health
City of Philadelphia Public Health Department
Alabama Department of Public Health
Virginia State Health Department
District of Columbia Department of Health
Louisiana Department of Health
One additional award will fund a national organization to support training and technical assistance for the programs noted above. The organizations funded under that piece of the effort is:
Health HIV (Washington, D.C.)