Infectious Disease Initiative Year in Review 2018


A MESSAGE FROM JEFFREY S. CROWLEY, PROGRAM DIRECTOR OF INFECTIOUS DISEASE INITIATIVES

World AIDS Day is December 1, and it has been another incredibly busy and productive year at the O’Neill Institute. The O’Neill Institute has expanded its Infectious Disease Initiatives with new projects and activities in the past year. The Infectious Disease Initiatives work to focus US domestic efforts to respond to the ongoing HIV epidemic, educate the public and support policy responses to promote access to curative Hepatitis C treatment, and address infectious disease threats associated with drug use epidemics across the US, including the unfolding opioid crisis. We have continued to work hard to build upon the progress made in recent years and to keep policymakers and community stakeholders committed to ending the epidemics of HIV and hepatitis in the United States and around the world.

I welcome Regina LaBelle who recently joined the O’Neill Institute as the Program Director of the Addiction and Public Policy Initiative, and I am excited to formalize collaboration between her initiative and the Infectious Disease Initiatives. Regina’s expertise and leadership will bolster our efforts to respond to the HIV and Hepatitis C epidemics associated with the opioid crisis and other drug use.

INFECTIOUS DISEASE PROJECT UPDATES

With support from amfAR, we completed a project examining critical policy issues that impact access, availability and acceptability of pre-exposure prophylaxis (PrEP) and long-acting agents, which are innovative forms of PrEP and HIV treatment that are under development and do not require daily pill taking. In July 2018, amfAR released four reports, Long-Acting HIV Treatment and Prevention Are Coming: Preparing for Potential Game Changers, prepared by Jeffrey Crowley and Sean Bland. The reports highlight the education and policy dialogues needed to prepare for innovative long-acting products for HIV treatment and prevention and include: (1) an Overview, summarizing the need for and major policy issues related to extending access to long-acting agents; (2) From Laboratory to Marketplace, discussing the Food and Drug Administration (FDA) review and approval process and special considerations for long-acting products; (3) Assessing the Payer Landscape, exploring the laws and policies that shape pharmaceutical access in public and private insurance; and (4) Defining the Intended Market for New Products, addressing issues such as adherence to non-daily products, consumer and provider acceptability, and cost-effectiveness. In addition to the reports, there is also a chart of long-acting agents under development to treat and prevent HIV infection. Later this year, amfAR will release another report that we authored, Expanding Access to Pre-Exposure Prophylaxis (PrEP) for Adolescents and Young Adults: Models for Addressing Consent, Confidentiality, and Payment Barriers.

With support from Gilead Sciences, we operate three separate projects: the Ryan White Policy Project, the Hepatitis Policy Project, and the HIV Prevention Project.

The Ryan White Policy Project was established in 2014 to consider issues related to sustaining and adapting the Ryan White HIV/AIDS Program within a changing health care environment. Through the project, Jeffrey Crowley and Sean Bland have continued to engage with federal policymakers and the HIV community over the past year on key issues related to the HIV health care system and the evolving role of the Ryan White Program. In April 2018, we held a stakeholder consultation meeting on leveraging the Ryan White HIV/AIDS Program to cure co-infected people with HIV of Hepatitis C infection. In connection with World AIDS Day this year, we are also releasing two new issue briefs as part of a Big Ideas series. The first issue brief, State and Local ‘End the Epidemic’ Plans Can Drive HIV Progress, is focused on promoting state and local plans to end the HIV epidemic, and the second issue brief, Leveraging the Ryan White HIV/AIDS Program to Make Rapid Start of HIV Antiretroviral Therapy Standard Practice, is focused on the role of the Ryan White Program in making rapid initiation of ART a reality.

The Hepatitis Policy Project was established in 2015 to focus on issues and barriers of access to effective treatments for Hepatitis C. In May 2018, Sonia Canzater and Jeffrey Crowley authored a report, Full of Life: The Stories of People Affected by Hepatitis C, that features the stories of people affected by Hepatitis C and underscores the need to do more to eliminate the damaging effects of the disease. In June 2018, we held a stakeholder consultation meeting on addressing legal and policy barriers to implementing syringe service programs and other harm reduction measures as strategies to address the Hepatitis C and opioid epidemics in the United States.

The HIV Prevention Project was established in 2017 to understand what is working in HIV prevention, identify issues and opportunities for progress, and describe future directions for HIV prevention. In March 2018, Jeffrey Crowley and Sean Bland authored the first report from the project, HIV Prevention in the United States: Federal Investments Are Saving Lives and Strengthening Communities, and also held a stakeholder consultation meeting on reducing HIV infections and supporting engagement in care among Latinx gay and bisexual men. In July 2018, we held a stakeholder consultation meeting on molecular HIV surveillance to examine the promise and risk of this new technology.

Other work within the Infectious Disease Initiatives has been funded by NMAC, the Elton John AIDS Foundation, and Georgetown University’s Global Health Initiative. With support from NMAC, we completed work on a Blueprint for HIV Biomedical Prevention, a two-part report providing a snapshot of community and provider experiences with biomedical HIV prevention (including treatment as prevention, pre-exposure prophylaxis, and post-exposure prophylaxis) and identifying critical issues to be addressed. In April 2018, NMAC released our second report, Expanding Access to Biomedical HIV Prevention: Tailoring Approaches for Effectively Serving Communities of Color.

We are working in collaboration with two DC-based organizations, Whitman-Walker Health and HIPS, to explore the impact of laws and policies on sex workers’ access to clinical care and social services, including HIV prevention and care services, in Washington, DC. This collaborative project was established in January 2017 with a grant from the Elton John AIDS Foundation. After conducting focus groups with sex workers and interviews with public health and legal professionals and representatives from DC government and law enforcement, we are currently writing a report describing our findings and making policy recommendations.

In October 2018, Sean Bland and Jeffrey Crowley, together with Georgetown University partners within the Office of the Senior Vice President for Research, received a Global Health Initiative collaborative research seed grant from Georgetown University to assess legal, policy, ethics, and human rights considerations of using new technology in public health surveillance for HIV.

PRESENTATIONS AND OTHER ACTIVITIES

On November 14, 2018, Jeffrey Crowley gave a presentation on “Promises and Risks of Using Emerging Public Health Tools to Prevent HIV” for the AIDS Law and Ethics Seminar at Georgetown University Law Center in Washington, DC.

On November 8 and 9, 2018, Jeffrey Crowley spoke to the ADAP Advocacy Association in Boston about current issues in HIV policy.

On November 7, 2018, Sean Bland gave a presentation on “HIV Criminalization in the United States and Beyond” for the Women’s Law and Public Policy Fellowship Program seminar at Georgetown University Law Center in Washington, DC.

On October 11 and 12, 2018, Sean Bland gave three presentations at the Gay and Lesbian Medical Association (GLMA) Conference in Las Vegas on legal issues affecting PrEP utilization, the benefits and risks of messaging around undetectable equals untransmittable (U=U), and improving laws and policies to protect LGBT sex workers and promote HIV prevention and care.

On September 30, 2018, Jeffrey Crowley gave a presentation on “Moving Closer to Ending the HIV Epidemic in the United States” for the Global Health Law Seminar at Georgetown University Law Center in Washington, DC.  

On September 28, 2018, Jeffrey Crowley presented on “The Role of Policy in Facilitating Productive Health Care Collaboration” at the Embassy of Italy in Washington, DC.

On September 26, 2018, Sean Bland and Jeffrey Crowley gave a presentation on “The Financing, Institutions, and Architecture of the AIDS Response in the United States” for the AIDS Law and Ethnics Seminar at Georgetown University Law Center in Washington, DC.

On September 25, 2018, Jeffrey Crowley presented on “Using the National HIV/AIDS Strategy to Reduce the Burden of HIV in the United States: Lessons for Effective Science Communication” at the National Institutes of Health in Bethesda, Maryland.

On September 6, 2018, Sonia Canzater presented on “Eliminating HCV among People Living with HIV” at the United States Conference on AIDS in Orlando, Florida.

On August 13, 2018, a stakeholder consultation meeting on molecular HIV surveillance organized by Jeffrey Crowley and Sean Bland as part of an HIV Prevention Project at the O’Neill Institute was discussed in the POZ article, “Will the Genetic Analysis-Based HIV Surveillance Safeguard Privacy?”

On August 8 and 9, 2018, Sean Bland gave two presentations at the National LGBT Bar Association Lavender Law Conference in New York on the benefits and risks of messaging around undetectable equals untransmittable (U=U) and improving laws and policies to protect LGBT sex workers and promote HIV prevention and care. 

On July 17, 2018, Jeffrey Crowley and Sean Bland presented at a briefing, “Long-Acting HIV Treatment and Prevention Are Coming: Preparing for Potential Game-Changers,” hosted by amfAR and the O’Neill Institute at Georgetown University Law Center in Washington, DC.

On June 21, 2018, Sonia Canzater moderated and presented on a panel, “An Overview of the Opioid Epidemic: What Is It and How Did We Get Here?,” during the O’Neill Institute Summer Program Public Health Law on the Frontlines: Countering Law and Policy Challenges to State and Local Innovations at Georgetown University Law Center.

On June 9, 2018, Jeffrey Crowley spoke during a panel discussion on addressing the most vulnerable populations at the International Conference on HIV Treatment and Prevention Adherence in Miami.

On May 30, 2018, Jeffrey Crowley was interviewed for and quoted in the Daily Beast article, “The President’s AIDS Panel Is Missing.”

On May 22, 2018, Jeffrey Crowley was interviewed for and quoted in the Vox article, “How PrEP, the Pill to Prevent HIV, May Be Fueling a Rise in Other STDs.”

On May 22, 2018, Jeffrey Crowley moderated a panel session on health disparities at the National Alliance of State and Territorial AIDS Directors (NASTAD) Annual Meeting in Washington, DC.

On May 19, 2018, Jeffrey Crowley presented on “Eliminating HCV among People with HIV: National Perspective and Preventing Infectious Disease Transmission among People Who Use Drugs – Lessons from Scott County” at the Latino HIV and Hepatitis National Conference in San Antonio, Texas.

On May 18, 2018, Jeffrey Crowley spoke to the ADAP Advocacy Association in Tampa, Florida about the prospects for reauthorization of the Ryan White HIV/AIDS Program.

On May 7, 2018, Jeffrey Crowley gave a presentation on “Access to Health Care: Is There a Right to Health in the US?” at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

On April 24, 2018, Jeffrey Crowley presented at a plenary session, “Catalyzing Advocacy and Moving Healthcare Forward,” at Synchronicity 2018, the National Conference on HIV, HCV, STDs, and LGBT Health in Arlington, Virginia. 

On April 24, 2018, Sonia Canzater presented on “From Policy to Program: Building Collaboration to Eliminate Hepatitis C” at Synchronicity 2018, the National Conference on HIV, HCV, STDs, and LGBT Health in Arlington, Virginia.

On March 26, 2018, Jeffrey Crowley presented at the opening plenary for AIDSWatch in Washington, DC.

On March 22, 2018, Jeffrey Crowley was interviewed for and quoted in a Vox article, “The New CDC Director Was Once Accused of Research Misconduct.”

On March 21, 2018, Jeffrey Crowley was interviewed for and quoted in a Politico article, “Trump Administration Taps AIDS Researcher to Lead CDC.”

On March 8, 2018, Sean Bland gave a presentation on “HIV Criminalization in the United States and Beyond” for the Women’s Law and Public Policy Fellowship Program seminar at Georgetown University Law Center in Washington, DC.

On February 26, 2018, Sean Bland spoke on a social justice and health equality panel as part of a virtual membership meeting organized by the Urban Coalition for HIV/AIDS Prevention Services (UCHAPS).

On February 23, 2018, Sean Bland spoke at a workshop session, “Youth, PrEP, Consent, etc.” at the HIV Law and Practice Conference in New Orleans, Louisiana.

On January 23, 2018, Sean Bland was interviewed for and quoted in the Slate article, “How Trump’s Policies Could Imperial LGBTQ Youth of Color Living with HIV.”

On January 15, 2018, Jeffrey Crowley was interviewed for and quoted in the article, “HIV Activists Prepare for What Lies Ahead in 2018,” featured on TheBody.com, a leading website dedicated to HIV/AIDS news, information, and support.

On January 3, 2018, Jeffrey Crowley was interviewed for and quoted in the Politico article, “Trump’s Firing Sets Back AIDS Prevention Efforts.”

On January 2, 2018, Jeffrey Crowley was quoted in the article, “Trump Administration Dismisses Members of HIV/AIDS Council as Nominations for New Council Near Deadline,” published in the American Journal of Managed Care.

On December 4, 2017, Jeffrey Crowley spoke about using data to inform the opioid epidemic response at the Kaiser Family Foundation in Washington, DC.

On November 30, 2017, Sean Bland gave a presentation on “HIV Criminalization and the Opioid Crisis: Where We Are Now and Where We Want to Be” at Georgetown University Law Center in Washington, DC.

RECENT PUBLICATIONS

Jeffrey S. Crowley and Sean E. Bland. State and Local ‘End the Epidemic’ Plans Can Drive HIV Progress. (December 2018 Release). O’Neill Institute/Georgetown Law.

Jeffrey S. Crowley and Sean E. Bland. Leveraging the Ryan White HIV/AIDS Program to Make Rapid Start of HIV Antiretroviral Therapy Standard Practice. O’Neill Institute/Georgetown Law. (December 2018 Release).

Sean E. Bland. Expanding Access to Pre-Exposure Prophylaxis (PrEP) for Adolescents and Young Adults: Models for Addressing Consent, Confidentiality, and Payment Barriers. amfAR. (December 2018 Release).

Jeffrey S. Crowley and Sean E. Bland. Long-Acting HIV Treatment and Prevention Are Coming: Preparing for Potential Game Changers. Overview. amfAR. July 2018.

Sean E. Bland and Jeffrey S. Crowley. Long-Acting HIV Treatment and Prevention Are Coming: Preparing for Potential Game Changers. From Laboratory to Marketplace. amfAR. July 2018.

Jeffrey S. Crowley and Sean E. Bland. Long-Acting HIV Treatment and Prevention Are Coming: Preparing for Potential Game Changers. Assessing the Payer Landscape. amfAR. July 2018.

Sean E. Bland and Jeffrey S. Crowley. Long-Acting HIV Treatment and Prevention Are Coming: Preparing for Potential Game Changers. Defining the Intended Market for New Products. amfAR. July 2018.

Sonia Canzater and Jeffrey S. Crowley. Full of Life: The Stories of People Affected by Hepatitis C. O’Neill Institute/Georgetown Law. May 2018.

Sean E. Bland and Jeffrey S Crowley. Expanding Access to Biomedical HIV Prevention: Tailoring Approaches for Effectively Serving Communities of Color. NMAC. April 2018.

Jeffrey S. Crowley and Sean E. Bland. HIV Prevention in the United States: Federal Investments Are Saving Lives and Strengthening Communities. O’Neill Institute/Georgetown Law. March 2018.

See All Publications

SELECTED O’NEILL INSTITUTE BLOG POSTS

National Gay Men’s HIV/AIDS Awareness Day: Responding to the HIV Epidemic among Black and Latino Gay and Bisexual Men By: Sean Bland

Being Sick Can Land You in Jail: Hepatitis C Criminalization By: Sonia Canzater

Congress Passes Major Opioid Response Legislation That Includes Funding to Improve Infectious Disease Surveillance By: Sonia Canzater

Rising STD Rates and the Importance of Integrating STD and HIV Resources By: Sean Bland

Modernization of North Carolina’s HIV Criminal Laws and Its Consequences By: Sean Bland

See All Blog Posts