On September 10-13, the 19th Annual United States Conference on AIDS (USCA) was held in Washington, DC. USCA brings together public health workers, advocates, policy makers, and people living with HIV to share strategies and ideas for how to tackle the HIV epidemic. The conference theme, “The numbers don’t lie: It’s time to end disparities,” was a clear call to action and powerful messages to this end were delivered throughout the conference.
This year’s conference included “Pathways” on four pressing issues, including hepatitis. NACCHO was honored to participate in the hepatitis pathway with colleagues and partners from across the country. The pathway was coordinated by the National Alliance of State and Territorial AIDS Directors (NASTAD) and highlighted the growing need to address hepatitis B and C (HBV and HCV), especially among high-risk and vulnerable populations; new opportunities resulting from curative treatment for HCV; and the critical need to address hepatitis within the HIV context. Nearly one-third of people living with HIV are affected by either HBV or HCV and certain subgroups, such as persons who inject drugs, have even higher rates of co-infection. Viral hepatitis progresses faster and causes more liver-related health problems among people with HIV than among those who do not have HIV. As such, HIV programs are a critical pathway to the necessary expansion of viral hepatitis services, including screening, vaccination, confirmatory testing, and referral to care and treatment.
NACCHO’s Director of HIV, STI, & Viral Hepatitis, Gretchen Weiss, participated on the presenting panel for the “Integrating Hepatitis Services into HIV Programs” session with colleagues Corinna Dan, Viral Hepatitis Policy Advisor in the Office of HIV/AIDS and Infectious Disease Policy at HHS; Lisa Stand, Senior Policy Associate at The AIDS Institute; and Chris Taylor, Senior Director of Viral Hepatitis at NASTAD. Presenters shared information about provisions under the Ryan White Program and the Affordable Care Act to support viral hepatitis services, data from a national survey about how health department HIV programs are supporting HCV testing, examples of how HIV programs have integrated viral hepatitis services, and tools and resources to support service integration efforts. All of the presenters’ slide presentations are linked to at the end of this article.
NACCHO’s presentation highlighted the role of local health departments across the HCV care continuum, discussed motivating factors for integrating services, and shared examples from the Champaign-Urbana Health District in Illinois and the San Francisco Department of Public Health of how local health departments have integrated hepatitis services into their HIV programs. Key to the success of integration in Champaign-Urbana was a focus on cross training staff, which has allowed the health department to provide needed services to the community it serves. San Francisco leveraged its existing HIV program infrastructure and capacity and used funding from the Substance Abuse Prevention and Treatment Block Grant HIV Set Aside Funds for Integrated Services to create a Viral Hepatitis Coordinator position to serve in a similar capacity to the CDC-funded Viral Hepatitis Prevention Coordinators. Another key to success for both health departments was leadership and support from health department and community champions.
Integrating hepatitis services into HIV, as well as STI, programs is an important strategy for supporting the provision of services that might otherwise not be provided due to lack of funding, infrastructure, capacity, and trained personnel. However, it must also be recognized that while overlapping populations are affected by HIV and hepatitis (in particular HCV), there are differences and each has its own programmatic needs that we must be cognizant of and work to address, accordingly. We must also continue to advocate for increased and consistent funding for hepatitis services so that health departments can appropriately support HCV testing, treatment, and prevention in their communities. As Chris Taylor stated in his presentation, “Our [hepatitis] house is on fire, and we need to use everything we have [to fight it].”
NACCHO encourages its members to consider what can be done locally to address hepatitis and to take action. As Corinna Dan discussed in her presentation, the Stakeholder’s Workbook accompanying the HHS Action Plan for the Prevention, Care, and Treatment of Viral Hepatitis is a helpful tool for facilitating opportunities to talk through potential activities, challenges, tools, resources, and partnerships. We also encourage you to visit NACCHO’s website to learn more about our hepatitis work, including a Web-based educational series focused on increasing local health department knowledge, skills, and abilities related to improving HCV testing and linkage to care in their communities.
Slide Presentations from the “Integrating Hepatitis Services into HIV Programs” Session