Compared with traditional measures of scientific impact, the CDC Science Impact Framework more broadly, directly, and quickly assesses impact of public health science. For 20 CDC-funded HIV prevention projects that were conducted during 2018-2022, health departments documented impact, based on CDC Science Impact Framework domains: Disseminating Science, Creating Awareness, Catalyzing Action, Effecting Change, and Shaping the Future. Health departments reported 282 impacts: the most common were new partnerships (n = 17, Catalyzing Action), capacity building (n = 16, Effecting Change), new projects or initiatives begun (n = 15, Shaping the Future), new collaborations (n = 14, Catalyzing Action), improved program (n = 13, Shaping the Future), new guidelines or practices (n = 13, Effecting Change), and informed persons affected by work (n = 13, Creating Awareness). Health departments documented substantial impact with a simple, timely, and broad approach. Demonstrating impact is important for community-based organizations, funders, and others interested in public health and helps them better understand the value of public health.

Partner notification services (PNS) offers opportunities to discuss HIV pre-exposure prophylaxis (PrEP) and provide referrals. We evaluated the PrEP care cascade among men who have sex with men (MSM) engaging in PNS within a sexually transmitted infections clinic. Among 121 MSM eligible for PrEP during PNS, 21% subsequently initiated PrEP.

CONTEXT: The Centers for Disease Control and Prevention recommends that all persons aged 13 to 64 years are tested for human immunodeficiency virus (HIV). However, results from US surveys show that 50% of persons and less had ever tested for HIV. PROGRAM: The Centers for Disease Control and Prevention annually funds 60 health departments to conduct comprehensive HIV prevention and surveillance activities that include HIV testing. IMPLEMENTATION: We selected the 31 health departments with quality data (ie, ≤20% missing or invalid values for variables to verify linkage to HIV medical care and new HIV diagnoses) in 2019. Main outcomes were new HIV diagnoses, linkage, and pre-exposure prophylaxis (PrEP) awareness and referrals. We used SAS 9.4 to conduct descriptive, chi-square, and multivariate regression analyses. Our objectives were to determine outcomes and characteristics of persons in non-health care settings who tested for HIV for the first time. EVALUATION: Compared with persons who previously tested for HIV, persons who tested for the first time were more likely to be aged 13 to 29 years than aged 30 years and older (62.0% [24 295/39 192] vs 42.1% [61 911/147 087], P < .001) and have a higher percentage of new HIV diagnoses (0.6% [242/39 320] vs 0.5% [667/147 475], P < .001). Among persons who tested for the first time, overall percentages of linkage, PrEP awareness, and PrEP referral were 73.4%, 33.3%, and 30.8%, respectively. Compared with referent groups, persons who tested for the first time in the South and had a new HIV diagnosis were less likely to be linked (adjusted prevalence ratio [aPR] = 0.72, 95% confidence interval [CI]: 0.59-0.89); persons who inject drugs were less likely to be aware of PrEP (aPR = 0.84, 95% CI: 0.77-0.91); and persons in the Northeast were less likely to receive PrEP referrals (aPR = 0.28, 95% CI: 0.26-0.31). DISCUSSION: Non-health care sites should consider increasing HIV testing, PrEP awareness, and prompt referrals to PrEP and HIV treatment services for persons who have never previously tested.

CONTEXT: During the conduct of the described demonstration project (2012-2015), the Centers for Disease Control and Prevention funding standard for HIV testing was 1.0% newly diagnosed positivity in non-health care settings. For linkage to HIV medical care, the National HIV/AIDS Strategy goal was 85%, and the funding standard was 80% (the Centers for Disease Control and Prevention and National HIV/AIDS Strategy had no other quantified goals/standards relevant to the project). OBJECTIVE: To determine aggregate quantitative results of HIV/STD testing and engagement in HIV care. DESIGN: Information sources used for this case study analysis included the Louisiana Department of Health funding application, progress and final reports submitted to the Centers for Disease Control and Prevention, and records of communications between these agencies. SETTING: Six community-based Wellness Centers throughout Louisiana. PARTICIPANTS: Gay and bisexual men and transgender persons. MAIN OUTCOME MEASURES: New HIV/STD diagnoses from testing, linkage to HIV care, and reengagement in HIV medical care. RESULTS: The percentage of persons who were newly diagnosed with HIV was 1.4% (44/3214). Of the newly diagnosed persons, 91% (40/44) were linked to HIV medical care. Of persons who were identified as out of care, 83% (5/6) were reengaged in HIV medical care. STD testing results showed that 9.0% (294/3251) of the syphilis tests were positive, and 8.3% (803/9719) of the chlamydia/gonorrhea tests were positive. The pharyngeal chlamydia/gonorrhea positivity was 7.6% (256/3375); the rectal chlamydia/gonorrhea positivity was 13% (374/2948); and the urine chlamydia/gonorrhea positivity was 5.1% (173/3396). CONCLUSIONS: The demonstration project was successful. The results were used to discontinue funding for a less effective HIV screening program, continue demonstration project activities with other funds, and make policy changes so that extragenital screening for chlamydia/gonorrhea is now the standard at Louisiana clinics that serve gay and bisexual men and transgender persons.

INTRODUCTION: From 2012 through 2015, the Centers for Disease Control and Prevention (CDC) provided funding to 5 health departments for demonstration projects using HIV surveillance data to link people with newly diagnosed HIV to care. We assessed how well these health departments established linkage to care, how the demonstration projects helped them with this work, and if they sustained these activities after CDC funding ended. MATERIALS AND METHODS: We obtained quantitative and qualitative data on linkage-to-care activities from health department communications and progress reports submitted to CDC. We calculated and combined linkage-to-care results for the 5 health departments, and we compared these results with the combined linkage-to-care results for 61 health departments that received CDC funding for routine HIV prevention activities (eg, HIV testing, linkage to and reengagement in HIV care, HIV partner services) and for the same 5 health departments when they used only routine HIV prevention activities for linkage to care. RESULTS: Of 1269 people with a new HIV diagnosis at the 5 health departments, 1124 (89%) were linked to care, a result that exceeded the 2010-2015 National HIV/AIDS Strategy goal (85%), the CDC Funding Opportunity Announcement performance standard (80%), and combined results for the 61 health departments (63%) and the same 5 health departments (66%) using routine HIV prevention activities. Benefits of the projects were improved collaboration and coordination and more accurate, up-to-date surveillance data. All health departments continued linkage-to-care activities after funding ended. PRACTICE IMPLICATIONS: Using HIV surveillance data to link people with HIV to care resulted in substantial clinical and public health benefits. Our observations underscore the importance of collaboration among medical providers, public health staff members, community-based organizations, and people with HIV to ensure the best possible clinical and public health outcomes.

CONTEXT: Partner services are a broad array of services that should be offered to persons with human immunodeficiency virus (HIV) and that are based on a process through which HIV-infected persons are interviewed to elicit information about their sex and needle-sharing partners. Human immunodeficiency virus testing of partners can result in a high yield of newly diagnosed HIV positivity, but despite this yield and the benefits of partners knowing their exposures and HIV status, partner services are often not conducted. OBJECTIVE: We sought to determine the newly diagnosed HIV positivity and benefits to 2 health departments that conducted demonstration projects that focused on statewide HIV partner services. DESIGN: The main sources of information used for this case study analysis included the health department funding applications, progress reports and final reports submitted to the Centers for Disease Control and Prevention, and records of communications between Centers for Disease Control and Prevention and the health departments. Required quantitative reporting included the number of partners tested and the number of partners with newly diagnosed confirmed HIV infection. Required qualitative reporting included how health departments benefited from their demonstration project activities. SETTING: Hawaii and New Mexico. PARTICIPANTS: Sex and needle-sharing partners of persons who were newly diagnosed with HIV infection. INTERVENTION: The use of HIV surveillance data to initiate statewide HIV partner services. MAIN OUTCOME MEASURE: Newly diagnosed HIV positivity. RESULTS: During 2012-2015, the newly diagnosed HIV positivity among partners was 18% (78/427): 16% (17/108) in Hawaii and 19% (61/319) in New Mexico. The health departments benefited from improved collaborations among HIV prevention program and surveillance staff and among the health departments, providers, and AIDS service organizations. CONCLUSIONS: Hawaii and New Mexico each achieved a high newly diagnosed HIV positivity and benefited from improved local collaborations. As a result of the success of these projects, both health departments have continued the activities since the end of category C funding by securing alternative funding sources.

For maximal public health impact, staff from the disciplines of program and science need to closely work together. For this commentary, we define program as work that builds and maintains a public health infrastructure with policies, plans, and capacity for the provision of essential services and interventions.1–4 We define science as work that is based on standardized methods of information collection, data management and analysis, continuous quality improvement,5–7 and information dissemination that includes the domains of surveillance,8 epidemiology,9 evaluation,10 and economics.11 Two recent strategies in the field of human immunodeficiency virus (HIV)/sexually transmitted infections are helping improve the integration of program and science with science-led activities.12–15 In this commentary, we summarize results from the use of a different strategy, which integrates program and science with program-led activities. | As part of a new funding cycle that began in January 2012, the Centers for Disease Control and Prevention (CDC) established cooperative agreements with 61 health departments under Funding Opportunity Announcement (FOA) PS12-1201 to conduct comprehensive routine HIV prevention services (known as Category A), which included HIV testing, partner services, and linkage and reengagement to HIV medical care.1 In March 2012 under this same FOA, CDC awarded 30 of the 61 health departments competitive funding to conduct their own high-impact HIV prevention16 nonresearch demonstration projects (known as Category C) that had to be consistent with the 2010–2015 National HIV/AIDS Strategy (NHAS).17 Category C projects were funded for four years through December 2015 and conducted by health departments (24 state, 2 county, and 4 city) in all U.S. Census Bureau regions.

CONTEXT: In 2010, the Centers for Disease Control and Prevention (CDC) implemented a national data quality assessment and feedback system for CDC-funded HIV testing program data. OBJECTIVE: Our objective was to analyze data quality before and after feedback. DESIGN: Coinciding with required quarterly data submissions to CDC, each health department received data quality feedback reports and a call with CDC to discuss the reports. Data from 2008 to 2011 were analyzed. SETTING: Fifty-nine state and local health departments that were funded for comprehensive HIV prevention services. PARTICIPANTS: Data collected by a service provider in conjunction with a client receiving HIV testing. INTERVENTION: National data quality assessment and feedback system. MAIN OUTCOME MEASURES: Before and after intervention implementation, quality was assessed through the number of new test records reported and the percentage of data values that were neither missing nor invalid. Generalized estimating equations were used to assess the effect of feedback in improving the completeness of variables. RESULTS: Data were included from 44 health departments. The average number of new records per submission period increased from 197 907 before feedback implementation to 497 753 afterward. Completeness was high before and after feedback for race/ethnicity (99.3% vs 99.3%), current test results (99.1% vs 99.7%), prior testing and results (97.4% vs 97.7%), and receipt of results (91.4% vs 91.2%). Completeness improved for HIV risk (83.6% vs 89.5%), linkage to HIV care (56.0% vs 64.0%), referral to HIV partner services (58.9% vs 62.8%), and referral to HIV prevention services (55.3% vs 63.9%). Calls as part of feedback were associated with improved completeness for HIV risk (adjusted odds ratio [AOR] = 2.28; 95% confidence interval [CI], 1.75-2.96), linkage to HIV care (AOR = 1.60; 95% CI, 1.31-1.96), referral to HIV partner services (AOR = 1.73; 95% CI, 1.43-2.09), and referral to HIV prevention services (AOR = 1.74; 95% CI, 1.43-2.10). CONCLUSIONS: Feedback contributed to increased data quality. CDC and health departments should continue monitoring the data and implement measures to improve variables of low completeness.

This study describes the prevalence and correlates of past-year intimate partner violence (IPV) among displaced women. We used bivariate and multivariate analyses to assess the relationships between IPV and select variables of interest. Multivariate logistic regression modeling revealed that women who had experienced outsider violence were 11 times as likely (adjusted odds ratio [AOR] = 11.21; confidence interval, CI [5.25, 23.96]) to have reported IPV than women who had not experienced outsider violence. IPV in conflict-affected settings is a major public health concern that requires effective interventions; our results suggest that women who had experienced outsider violence are at greater risk of IPV.

Safety and substantial efficacy have now been proven for daily antiretroviral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate (TDF) in combination with emtricitabine (FTC) for HIV-uninfected men who have sex with men (MSM)1 as well as heterosexual men and women.2, 3 MSM and heterosexuals (who do not inject drugs) comprised 88% of the estimated new HIV infections in the U.S. in 2009 and have evident need for additional prevention methods to substantially lower the incidence of HIV infections.4 | A comprehensive national surveillance system exists for monitoring the diagnosis, treatment, and health effects of HIV infection.5, 6 Periodic multi-city surveys monitor HIV risk and protective behaviors in key transmission risk groups.7 An additional national program-monitoring and evaluation system assesses elements of HIV testing,8 behavioral,9 and structural prevention programs as delivered by community-based organizations and health departments funded by the CDC.

We used Centers for Disease Control and Prevention HIV Counseling and Testing System data from 2007 to determine the percentage and characteristics of persons newly identified as HIV-positive in US correctional facilities. The newly identified HIV positivity was 0.7%, and 30% of detainees newly identified with HIV were categorized as having low-risk heterosexual contact or no acknowledged risk. Correctional facilities should provide detainees with routine opt-out HIV testing, unless the prevalence of previously undiagnosed HIV infection has been documented to be less than 0.1%. (Am J Public Health. Published online ahead of print March 8, 2012: e1-e4. doi:10.2105/AJPH.2011.300614).

BACKGROUND: Little is known about how hospital organizational and cultural factors associated with implementation of quality initiatives such as the Institute for Healthcare Improvement's (IHI) 100,000 Lives Campaign differ among levels of healthcare staff. DESIGN: Evaluation of a mixed qualitative and quantitative methodology ("trilogic evaluation model"). SETTING: Six hospitals that joined the campaign before June 2006. PARTICIPANTS: Three strata of staff (executive leadership, midlevel, and frontline) at each hospital. RESULTS: Surveys were completed in 2008 by 135 hospital personnel (midlevel, 43.7%; frontline, 38.5%; executive, 17.8%) who also participated in 20 focus groups. Overall, 93% of participants were aware of the IHI campaign in their hospital and perceived that 58% (standard deviation, 22.7%) of improvements in quality at their hospital were a direct result of the campaign. There were significant differences between staff levels on the organizational culture (OC) items, with executive-level staff having higher scores than midlevel and frontline staff. All 20 focus groups perceived that the campaign interventions were sustainable and that data feedback, buy-in, hardwiring (into daily activities), and leadership support were essential to sustainability. CONCLUSIONS: The trilogic model demonstrated that the 3 levels of staff had markedly different perceptions regarding the IHI campaign and OC. A framework in which frontline, midlevel, and leadership staff are simultaneously assessed may be a useful tool for future evaluations of OC and quality initiatives such as the IHI campaign.

BACKGROUND: Until 2005, national-level data on the sex of sex partners that describe how primary and secondary syphilis affects men who have sex with men (MSM) of different races or ethnicities were not reported. OBJECTIVE: To present data from 27 states comparing trends in primary and secondary syphilis among MSM of different races or ethnicities. DESIGN: Review of case report data and regression analysis. SETTING: Federal database of case reports in the National Electronic Telecommunications System for Surveillance. PARTICIPANTS: Men reported to be MSM. MEASUREMENTS: Cases of primary and secondary syphilis per 100,000 males of matching race or ethnicity ("rates"), determined by using population data from the National Center for Health Statistics as the denominator to compare age and racial and ethnic differences. RESULTS: For each year during 2005 to 2008, 27 states from all U.S. census regions reported data on the sex of sex partners for 70% or more of male cases of primary and secondary syphilis. Regression analysis revealed significantly different trends in rates of primary and secondary syphilis: Absolute increases in rates among black MSM and Hispanic MSM were, respectively, 8.0 times and 2.4 times the absolute increase in rate among white MSM. By region, rates among MSM increased 30% in the Midwest, 48% in the South, 73% in the Northeast, and 77% in the West. By age group, the largest absolute increase in rates occurred among MSM aged 20 to 29 years. LIMITATION: Results from 27 states may not be generalizable to the United States as a whole. CONCLUSION: Rates of primary and secondary syphilis disproportionately increased among black and Hispanic MSM (compared with white MSM) and among young MSM. Care providers should offer counseling about safer sexual practices and screening for syphilis and other sexually transmitted infections when caring for MSM. PRIMARY FUNDING SOURCE: Centers for Disease Control and Prevention.

OBJECTIVES: We sought to determine whether Hispanic-White HIV testing disparities exist and to identify characteristics associated with newly diagnosed HIV among Hispanics. METHODS: We used 2007 HIV Counseling and Testing System data to compare test-level records of Hispanics and non-Hispanic Whites, and we conducted a multivariate logistic regression analysis to identify characteristics associated with newly diagnosed HIV. RESULTS: Relative to Whites, Hispanics were more likely to have had a positive HIV test result (1.2% versus 0.8%), to have newly diagnosed HIV (0.8% versus 0.6%), and to have test results returned and receive posttest counseling more than 2 weeks after testing (24.3% versus 21.5%). Newly diagnosed HIV among Hispanics was most strongly associated with being a man who has sex with men (MSM; adjusted odds ratio [AOR]=6.8; 95% confidence interval [CI]=6.1, 7.6), being both an MSM and an injection drug user (AOR=3.7; 95% CI=2.6, 5.3), and being aged 40 to 49 years (AOR=6.4; 95% CI=4.9, 8.2). CONCLUSIONS: Hispanic-White disparities exist with respect to rates of positive HIV test results and late return of results. HIV prevention strategies such as rapid testing should focus on Hispanic MSM.