MDHHS and local health departments are public health officials tasked with monitoring the health of the community and providing the basis of preventive action. This requires physicians, laboratory facilities, and other care providers to promptly report communicable diseases to MDHHS and local health departments to ensure timely investigations and follow up. 

The STI/HIV Operations and Resource System (SHOARS) will allow partners to engage with the diverse resources of the Division of HIV/STI Programs (DHSP). Design and development of SHOARS is moving along really well. SHOARS will improve the relationship between MDHHS and external partners to efficiently provide services for Michiganders who are at risk and/or living with HIV & STIs.

As part of the American Recovery Plan, The Centers for Disease Control and Prevention (CDC) provided supplemental funding to STI programs across the country to ‘hire and support Disease Intervention Specialists (DIS) to strengthen the capacity of state, tribal, local and territorial public health departments to mitigate the spread of COVID-19 and other infections.’ These funds are guaranteed for a minimum of five years and will allow DHSP, in partnership with several MDHHS programs, to expand the existing DIS workforce and establish a broadly trained staff that will respond to routine disease reports, as well as emerging threats/outbreaks. 

COVID-19 brought attention to the fact that our public health infrastructure was suffering; it also made people aware of what a DIS is and the important role they play in disease control. In 2022, DHSP will build on this awareness by launching a media campaign to ‘brand’ DIS as a valued resource when managing a health crisis as well as conduct a DIS gap assessment to inform funding initiatives.

During the planning phase for Michigan’s Ending the HIV Epidemic (EHE), a need was identified to increase representation of women, specifically Black women, and to improve HIV prevention, treatment, and care for women across all health care systems. Historically, many federally issued grants have prioritized men who have sex with men (MSM), young Black men who have sex with men (YBMSM), and transgender individuals. Due to those grant requirements, MDHHS has mainly supported agencies that primarily serve those populations; however, data consistently shows that women and youth are also disproportionally impacted by HIV and STIs. Utilizing the EHE planning group, data, and the unique inclusive opportunities that EHE funding allows, MDHHS established a relationship with Alternatives for Girls (AFG) to address this disparity.

AFG is an organization in Southwest Detroit who serves persons without housing and at-risk girls and young women via their robust shelter, prevention, and outreach programs. Their mission is to help them avoid violence, teen pregnancy, and exploitation, and help them access the support, resources, and opportunities to be safe, to grow strong, and to make positive choices in their lives.

MDHHS currently supports AFG to implement condom distribution as well as Popular Opinion Leader (POL) via their peer navigation program. POL is a community level HIV prevention intervention that seeks to leverage social influence principles in which key, well-trusted opinion leaders or community gate keepers are trained to endorse safer sexual behaviors in one-on-one conversations with their peer groups. To date, AFG has 10 peer educators who have hosted conversations and skills building workshops amongst their peers. Conversations and workshops were on the following topics: HIV, STIs, safe sex and condom use, self-care, conflict resolution and others. The estimated peer network is expansive, reaching up to 100 people and includes women, youth, and transwomen, individuals involved in commercial sex work, and individuals who may be victims of sex trafficking. In addition to reaching their peers through POL, AFG also hosts parent learning sessions where they discuss topics related to HIV/STIs and how to talk to their kids about substance use.

They also conduct street outreach and distribute harm reduction kits to persons without housing and commercial sex workers. During their street outreach, AFG peer navigators have distributed over 542 condoms and additional resources with HIV/STI and linkage to care information.

In efforts to further reduce disparities and expand testing opportunities, the HIV Prevention and EHE team intends to facilitate conversations between AFG and another health care agency in Detroit to identify collaborative opportunities for pop-up clinics at AFG to ensure that women and girls are receiving comprehensive services such as general health and wellness checks, OB/Gyn, and HIV/STI testing. This partnership between AFG and MDHHS has the potential to bridge the gaps in prevention and care for women and girls in the jurisdiction.

https://alternativesforgirls.org/

For several years, MDHHS has collaborated with the Centers for Disease Control and Prevention (CDC) on a public health project known as the Medical Monitoring Project (MMP). A random selection of 400 persons living with HIV (PLWH) in Michigan are selected each year for participation in this project. HIV care providers in Michigan will be receiving a letter from MDHHS if you are providing care for one or more persons selected for MMP. You will be subsequently contacted by phone to receive a list of those patients. We hope that you will encourage your patients to participate in this important public health initiative. For more information on the benefits of participation with MMP, click here.

Among NHBS participants in the Detroit Metro area, PrEP awareness increased from 6% in 2011 to 36% in 2019, while PrEP usage increased from <1% to 10%.

In each survey round, PrEP awareness and usage was highest amongst men who have sex with men (MSM). PrEP awareness was lowest among persons who inject drugs (IDU), while PrEP usage was lowest amongst heterosexuals (HET).

In the most recent cycle (2017-2019):

• 58% of MSM were aware of PrEP and 19% had taken PrEP
• 13% of IDU were aware of PrEP and 7% had taken PrEP
• 42% of HET in 2019 were aware of PrEP and <1% had taken PrEP
• PrEP awareness was highest in the 35-44 age group (52%); but PrEP usage was highest in the 18-24 age group (17%)
• 67% of new HIV diagnoses in the Detroit Metro Area were African American, but only 49% of those who had taken PrEP were African American
• PrEP awareness between high-risk males (37%) and female (35%) participants was similar, but usage was higher in males (13%) than females (2%)

With the Supreme Court striking down the Center for Disease Control’s eviction moratorium, tens of thousands of Michigan low-income households are closer to being evicted, but they don’t have to be! There are still millions of dollars available through the Michigan State Housing Development Authority’s (MSHDA) COVID Emergency Rental Assistance (CERA) program. Households below 80% Area Median Income who are at risk of eviction due to non-payment of rent may be eligible; and if the household applies for assistance, local courts are required to delay eviction proceedings for up to 45 days while the household works to obtain the funding. Applications and more information can be accessed at https://michigan.gov/cera. 

For low-income households living with HIV/AIDS who may need more long-term housing assistance, the Housing Assistance for Persons with AIDS (HOPWA) may be the best resource. For households in Wayne County, reach out to the HAPI program at the Detroit Health Department at 313-638-2881. Households in Lapeer, Livingston, Macomb, Oakland, and St. Clair can call OLHSA at 248-209-2672. For the rest of the state, reach out to the HOPWA Program Specialist at MDHHS, Lynn Nee at 517-275-2791 and she will connect you to the closest HOPWA program in your area.