World AIDS Day 2016: Local Health Department Leadership, Commitment, and Impact

By Alyssa Kitlas, HIV, STI, & Viral Hepatitis Program Analyst, NACCHO 

This story originally ran in NACCHO’s Essential Elements blog.

The U.S. Government theme for World AIDS Day 2016 is “Leadership. Commitment. Impact.” These themes resonate strongly with the work local health departments (LHDs) do every day to address HIV in their communities.

LHDs are key leaders in providing and assuring access to HIV prevention, care, and treatment for the communities they serve. As community health strategists, LHDs facilitate collaboration between public health, healthcare, social services, and other key stakeholders, such as community organizations and small businesses, to achieve more integrated and effective systems for HIV prevention and care. Over the past few years, this leadership and collaborative work with community partners has led to the successful development of local and state plans for ending the HIV epidemic, such as those for Fulton County (GA), San Francisco (CA), Houston (TX), and the State of New York. The value of health department leadership for reducing new HIV infections and improving outcomes across the HIV care continuum was highlighted in a recent study to generate hypotheses to explain declines in HIV incidence in Massachusetts, North Carolina, San Francisco, and Seattle. Researchers found that the most unifying observation was that leadership within health departments is critical to achieving success.

LHDs are committed to preventing new HIV infections, improving the lives of people living with HIV, and eliminating the social and structural injustices that result in health disparities. LHDs have demonstrated this commitment in their efforts to expand access to pre-exposure prophylaxis (PrEP). Some LHDs, like Hennepin County Public Health (MN) and Champaign-Urbana Health District (IL), have expanded access to PrEP by adding it to the services delivered via their health department clinics. Other LHDs are focusing their efforts on provider education, developing provider lists to help interested individuals navigate the services available in their community, and creating social marketing campaigns to increase awareness and knowledge of PrEP. To learn more about what LHDs are doing to support PrEP implementation, visit NACCHO’s PrEP Story Bank.

The impact of LHD efforts at the local level significantly contributes to our progress towards achieving the goals of the National HIV/AIDS Strategy. The 2015 HIV Surveillance Report, which was released by the CDC earlier this week, showed that the annual numbers and rates of HIV diagnosis decreased overall. However, youth and gay and bisexual men continue to be disproportionately impacted. LHDs are uniquely positioned to increase the impact of efforts to reduce HIV among these and other disproportionately impacted populations by providing data, contributing expertise, and collaborating with community partners to assure that these populations are reached through evidence-based and culturally competent interventions and services.

Additionally, a new CDC Vital Signs on HIV and injection drug use, released earlier this week, highlights the need to improve access to syringe services programs (SSPs). While HIV diagnoses among persons who inject drugs (PWID) has decreased, progress has been uneven, and the opioid epidemic presents a growing concern for the risk of HIV outbreaks among PWID, like the one seen last year in Scott County, Indiana. “The prescription opioid and heroin epidemics are devastating families and communities throughout the nation, and the potential for new HIV outbreaks is of growing concern,” said CDC Director Tom Frieden, M.D., M.P.H. “Our goal is for people to live long enough to stop substance use and not contract HIV or other serious infections while injecting – SSPs can help people accomplish both.” LHDs can improve access to SSPs by:

  • Using data and information to determine where harm reduction programs are most needed:
  • Directly running or supporting existing SSPs, or the establishment of new ones in areas of need;
  • Providing culturally competent and non-judgmental services to PWID, including HIV and hepatitis testing and referrals to medical care, substance use disorder treatment, and mental health services; and
  • Ensuring that Naloxone is widely available within the community.

World AIDS Day provides an annual opportunity to celebrate our accomplishments, remember those who have lost their lives to HIV and AIDS, and refocus our attention on what is still needed to end the epidemic in the United States and globally. Through the leadership, commitment, and impact of LHDs and partners at the local, state, national, and federal levels, we will end this epidemic.

To remain updated on World AIDS Day, follow and use the hashtag #WAD2016 on social media. And, if your health department is doing something to celebrate World AIDS Day, please share it with us @NACCHOalerts. To learn about NACCHO’s work to support LHD leadership, commitment, and impact on ending the HIV epidemic, visit our website.