Capacity Building Assistance (CBA) for HIV Prevention Programs to End the HIV Epidemic in the United States

This program will constitute a national CBA Provider Network (CPN) to deliver CBA services to an interdisciplinary HIV prevention workforce (e.g., professional, technical, clinical, and managerial staff) within CDC-funded state and local health departments and CBOs. In the United States, an estimated 1.2 million people are living with HIV. In recent years, the number of people with HIV (PWH) has increased while deaths have declined. Of PWH, about 87% were aware of their HIV status. In 2021, among people with diagnosed HIV, an estimated 75% received HIV medical care and 66% were virally suppressed. Promising progress has been made in HIV prevention as the estimated annual new HIV infections were 12% lower in 2021 (32,100 infections) compared to 2017 (36,500 infections). This decline was largely driven by a substantial decrease (34%) in new infections among 13- to 24-year-olds, mostly among gay and bisexual males. However, HIV prevention efforts must go further, and progress must be faster, for gains to equitably reach all populations and end the HIV epidemic. The National HIV/AIDS Strategy (NHAS) for the United States focuses on four goals: preventing new HIV infections, improving HIV-related health outcomes of people with HIV, reducing HIV-related disparities and health inequities, and achieving integrated, coordinated efforts that address the HIV epidemic among all partners. Successful HIV programs must recognize the syndemics that affect the people and places disproportionately affected by HIV. A syndemic is population-level clustering of social and health problems. In the context of HIV, a syndemic is when HIV clusters with one or more other diseases or health conditions within a specific population, driven by the contextual, structural and social factors that increase the adverse effects on the health of people and communities. Syndemics may include HIV, STIs, TB, viral hepatitis, overdose, and substance use, and other existing and emerging conditions or factors that may be related to or impact HIV. The Ending the HIV Epidemic in the US (EHE) initiative focuses on scaling up four sciencebased strategies in communities most affected by HIV across the country. The strategies are to diagnose all people with HIV as early as possible; treat people with HIV rapidly and effectively to result in sustained viral suppression; prevent new HIV transmissions by using proven interventions, including condom distribution, pre-exposure prophylaxis (PrEP), postexposure prophylaxis (PEP), and syringe services programs (SSP); and respond quickly to potential HIV outbreaks to get vital prevention and treatment services to people who need them. Toward achieving national HIV prevention goals, the Centers for Disease Control and Prevention (CDC) funds state and local health departments and community-based organizations (CBOs) to plan, integrate, implement, evaluate, and sustain HIV prevention and surveillance programs, prioritizing people disproportionately affected by HIV including gay, bisexual, and other men who have sex with men, in particular Black, Latino, and American Indian/Alaska Native men, Black women, transgender women, youth aged 13-24, and people who inject drugs. Racism, HIV stigma, discrimination, homophobia, poverty, and barriers to health care continue to drive disparities in HIV prevention. Building individual competencies and technical expertise among staff, strengthening organizational capacities, and enabling supportive structural environments are critical strategies Page 5 of 81 in addressing operational challenges for more effective HIV prevention and surveillance programs. Reflecting CDC’s continued investment in improving the performance of the nation’s HIV workforce, this NOFO will support the provision of capacity building assistance (CBA) services, including training and technical assistance (TA).