Following are the oral comments presented to CHAC on behalf of the Beyond AIDS Foundation, on April 20, 2021. CHAC is the official advisory committee to the Centers for Disease Control and Prevention (CDC), and the Health Resources and Services Administration (HRSA) concerning HIV, viral hepatitis, and sexually transmitted infections. A longer written document was also submitted.
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I am Ronald Hattis, Secretary and Past-President of the Beyond AIDS Foundation. This is a brief synopsis of our written testimony, which I hope committee members will read for the rationale and details of our recommendations. For over 3 decades we have promoted improved strategies for HIV prevention and control. Among our leaders are former major metropolitan STD and HIV directors, health officers, EIS Officers, PACHA members, and HIV and other I.D. specialists. We hope to renew ongoing direct dialog with both agencies, and hope for inclusion in future CDC consultations.
Our recommendations are based in part on findings of our survey of state and territorial HIV/AIDS Directors, published in 2019 in AIDS Education and Prevention (and provided to the committee). This revealed marked inconsistencies of policy and practices among jurisdictions. Our most important recommendations for CDC and HRSA, include:
- That more oversight be provided and accountability required by both agencies
regarding adherence to grant conditions. We recommend enhanced routine site visits
for evaluation, education and guidance.
- That CDC recommendations, and grant requirements, specify more standardized public health outreach to newly diagnosed patients and their providers, particularly for rapid linkage to care and partner services. 20% of states and territories did not routinely contact all diagnosed patients and 40% did not try to contact all known providers.
- That CDC recommend, and include as a grant requirement, the monitoring of MISSED viral load results, none received in the past year for diagnosed patients, suggesting no active treatment.
- That monitoring of genotype results become a CDC recommendation, with results forwarded to CDC for analysis. Only 38% of jurisdictions even received such results.
- That all jurisdictions be encouraged to supplement CDC grants with their own money
for HIV prevention. 28% of jurisdictions had no prevention funds other than their CDC
grants.
That there be more joint screening efforts for HIV, STIs, and viral hepatitis, and
more joint health education about their shared prevention measures, and that PrEP
providers urge condom use to prevent other STIs.
- That HRSA grant recipients, be expected to attempt to contact patients to remind them
of upcoming appointments, to follow up on missed appointments, and when possible, 2
to schedule HIV care on the same half day as primary and specialty care. Providers
funded through other sources should be encouraged to act similarly.
- That PrEP costs be covered for uninsured patients, especially seronegative partners
of Ryan White patients. HRSA efforts in this direction are appreciated.
- Finally, that training be made available nationwide to primary care providers on starting immediate HIV treatment. Presentations that I have used to provide such training are linked from our written testimony.
I am honored to have had this opportunity to provide input today. I welcome any
questions, now or after this meeting
