Recap of HIV, STI, Harm Reduction, and RIM Sessions at NACCHO 360

We couldn’t imagine a more successful NACCHO 360- With 183 talented speakers and 1,511 eager listeners, this conference was representative of the best and brightest in local public health. We know there was a lot of information, so if you missed some, you’re in the right place. This year’s conference featured expertise from local health departments and their partners from around the country. We heard from several harm reduction and HIV/STI specialists about a multitude of different topics, most of which are explored below. You’ll find resources, recaps and relevant updates on all things harm reduction, HIV and STIs.

Promoting Local Harm Reduction Efforts: NACCHO Policy Statement Launch and Meet and Greet

In May 2022, NACCHO released an updated harm reduction policy statement. At this year’s NACCHO 360, members of the HIV, STI, and Viral Hepatitis (HSH) team (Kat Kelley, Julie Karr, Anjana Rao and Emily Lawson) hosted Promoting Local Harm Reduction Efforts: NACCHO Policy Statement Launch and Meet and Greet to share with participants highlights from the policy statement and its policy and practice recommendations for LHDs. Staff then facilitated a robust discussion with participants on how LHDs may operationalize those recommendations and how NACCHO could support LHDs in these efforts. The session resulted in nearly 20 sign-ups for NACCHO’s harm reduction list serv to stay up to date with NACCHO’s harm reduction work and be involved in the future. The HSH team is planning to release a series of practice and policy briefs in the fall and winter of 2022. Feedback and discussion from this event will be woven into these briefs. As the U.S. continues to face a growing opioid overdose crisis, NACCHO is committed to supporting LHDs and their harm reduction efforts to meet people where they are, build trust with people who use drugs (PWUD), and equip individuals with the tools and information to protect themselves from infectious diseases and overdose.

Poster: Strengthening Monitoring & Evaluation at Syringe Services Programs: Opportunities, Needs, & Priorities

In partnership with the University of Washington (UW) and with support from the Centers for Disease Control and Prevention, NACCHO has worked to build the capacity of syringe services programs (SSPs) to collect, manage, and use data for program and policy improvement. Through this project, NACCHO and UW have developed a deeper understanding of the benefits of SSP monitoring and evaluation (M&E) and what SSPs need to strengthen their M&E efforts. At NACCHO 360, NACCHO’s Kat Kelley (Senior Program Analyst, HIV, STI, & Viral Hepatitis) and UW’s Kelly Knudtson (SSP Monitoring and Evaluation Technical Assistance Program Manager), presented a poster characterizing the findings of this project. The poster identifies the major barriers that SSPs face, what SSPs’ own M&E priorities and goals are, and what they need to achieve them. The poster includes recommendations for SSPs and organizations that partner with and fund them, including how LHDs can strengthen their own SSP M&E efforts and partner with local SSPs to build their capacity to collect and use data for public health purposes.

Barriers to Equitable Healthcare in Refugee, Immigrant, and Migrant (RIM) Communities

NACCHO, in partnership with the University of Minnesota’s National Resource Center for Refugees, Immigrants, and Migrants (NRC-RIM) and made possible with awards from the Centers for Disease Control and Prevention (CDC), aids local health departments and community-based organizations (CBOs) in their work with RIM communities that are disproportionately affected by COVID-19. Program sites directly support RIM communities to rapidly scale-up COVID-19 prevention and mitigation through COVID-19 education, messaging, testing, contact tracing, and vaccination with local RIM populations. By strengthening partnerships with RIM communities, and collaboratively designing and implementing sustainable approaches to reduce COVID-19 infections, the program is intended to identify and enhance best practices to bolster public health efforts with marginalized communities during this crisis and beyond the ongoing viral pandemic.

Two RIM program sites worked collaboratively to preset their work in mitigating the accessibility barriers to equitable healthcare in RIM communities, specifically in the scope of COVID-19.

NYIC, New York Immigrant Coalition, focused on community engagement; their work involved outreach and education as well as COVID-19 vaccination pop-ups. NYIC collaborates with Academy of Medical and Public Health Services (AMPHS), as well as the Department of Health and Mental Hygiene (DOHMH), to build a partnership model that utilizes the assets and strengths of the respective agencies to enhance their impact on the most marginalized communities, providing a strong foundation for continued collaboration to promote public health beyond the scope of this project.

Champaign-Urbana Public Health District (C-UPHD) focused on bringing partners together, their strategic partnerships supported outreach, heath education and information sharing to RIM communities, on culturally competent prevention messaging, testing, contact tracing, support services and financial assistance during isolation and quarantine, and COVID-19 vaccination.

Local Health Department and Community Roles in Financing and Delivering Pre-Exposure Prophylaxis (PrEP) to End the HIV Epidemic in the United States: Reflections on a Policy Proposal

NACCHO, Advocates for Youth, and PrEP For All partnered to host “Local Health Department and Community Roles in Financing and Delivering Pre-Exposure Prophylaxis (PrEP) to End the HIV Epidemic in the United States: Reflections on a Policy Proposal.” Jeremiah Johnson, PrEP Project Manager at PrEP for All, outlined key policy mechanisms that would improve access to PrEP for HIV prevention for uninsured and marginalized communities, followed by a presentation by Julia Zigman of NACCHO highlighting the role of local health departments in implementing PrEP and their unique needs in a national PrEP program. The session was concluded by Armonté Butler, Associate Director of LGBTQ Health & Rights at Advocates for Youth, who described barriers to youth access to PrEP and crucial considerations for the inclusion of youth in HIV prevention policies. During a panel discussion, the speakers discussed how a national PrEP program can address structural barriers to healthcare access as well as ways health departments and community partners can collaborate to reduce health inequities in HIV outcomes, particularly among high-risk populations such as youth.

Detecting and Responding to HIV Clusters to Improve Care and Prevention

The respond pillar is the fourth pillar of the Ending the HIV Epidemic initiative in the U.S., and it focuses on the need to detect and respond to HIV clusters. HIV clusters are an indication that our HIV prevention and care services are not reaching people who need them, and cluster response guides the other HIV EHE strategies (diagnose, treat, prevent) to best reach the affected networks.

Dr. Demetre Daskalakis, Director of the Division of HIV Prevention at CDC, and Dr. Alexa Oster, Chief of Detection and Response Branch, Division of HIV Prevention, CDC) were joined by Dr. Philip Peters, Medical Officer at the Office of AIDS at the California Department of Health, and Patrick Salazar, of Kern County California at NACCHO’s recent annual conference to share a national perspective and framework on cluster detection and response, and describe how it is being implemented at the local level.

Dr. Oster described different approaches being used to identify clusters, including use of HIV molecular data, which is made available to the national HIV Surveillance System through routine HIV drug resistance testing; and went on to discuss response strategies based on the fundamental building block of community engagement, which were exemplified in presentations by Dr Peters and Dr. Kern.

Implementing a Status Neutral Approach to HIV Services at the Local Level

Too often, access to services needed by people to stay engaged in HIV treatment or prevention is determined by HIV status. Because of how funding streams are structured, people living with HIV may have access to housing, transportation, case management and other services. But for people who are HIV negative and concerned about their risk, those same services that can support risk reduction may not be available.

Status Neutral is a new approach to HIV education, testing, and treatment that proposes the same approach for engagement and health care delivery, regardless of one’s HIV status. By centering care around the holistic needs of the individual, and not around disease specific needs, HIV status is normalized within the health care system, stigma is reduced, and access to a variety of needed services is enhanced. A status neutral approach can be achieved by the combination of diverse funding streams, purposeful collaborations with community partners, and establishment of health care sites focused on “one-stop shopping” for HIV, STI, harm reduction, and social services.

Dr. Demetre Deskalakis, Director of CDC’s Division of HIV Prevention recently shared CDC's vision of a status neutral report at NACCHO’s annual conference, and two local health departments (Red Door Clinic in Minneapolis, and DC Health and Wellness Center in Washington DC), described the successes and challenges of their efforts to create integrated, status neutral services at the local level.

Global-Local Health Exchange: Utilizing WHO’s Global Mental Health Resources for Local Public Health Challenges

NACCHO’s HIV, STI, and Viral Hepatitis (HSH) team held a sharing session, “Global-Local Health Exchange: Utilizing WHO’s Global Mental Health Resources for Local Public Health Challenges,” which attracted a full and engaged audience at the end of the second day of the conference. This sharing session, which was facilitated by Lucy Slater and Jamee Kuznicki of the HSH team, focused on sharing results and learnings from the Global to Local Health Exchange project, a small project funded by the Robert Wood Johnson Foundation whose aim was to support health departments in adapting a chosen global health model or practice in a local public health setting. Project leads from two local health departments – Anita Ray and Chelsea Simms (Calvert County Behavioral Health, MD) and Megan McClintock and Heidi Bettcher (Housatonic Valley Health District, CT) – shared their experiences and challenges in adapting and implementing various tools from the WHO’s mental health toolkit to better address mental health needs in their communities through non-specialists. The session also featured insights from experts in the global mental health field – Dr. Shekhar Saxena (Harvard School of Public Health) and Dr. Oliveira e Souza (Pan-American Health Organization) – and concluded with an informative discussion in which participants brainstormed ideas around what support and resources local health departments would need to implement new or innovative ideas and practices from the global health space.

Our specialists got to share invaluable information and resources with those in attendance of NACCHO 360. Although we are still excited about the success of this year's conference, we are eager to start planning for next year. Mark your calendars for July 11th-13th 2023 in Denver, Colorado! For more information regarding NACCHO 360 or NACCHO’s work in general, please visit our website. Become a member, stay connected with us, and sign up for future meetings and conferences- we'd love to have you as part of the NACCHO family.

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