Health Reform and Reducing Disparities: Sexually Transmitted Diseases and HIV/AIDS

Health Reform and Reducing Disparities: Sexually Transmitted Diseases and HIV/AIDS

December 3, 2010, 1:00 pm to 5:00 pm

State legislators, primarily from CSG’s Eastern Regional Conference states, attended a 4-hour session to learn more about health reform and state policies can reduce health disparities related to sexually transmitted diseases (STDs) and HIV/AIDS.

Participants heard from national experts about how federal and state health reforms can help reduce health disparities. Speakers from the Centers for Disease Control and Prevention (CDC), the Massachusetts Dept. of Public Health, and medical and community services providers gave background information on the epidemic of STDs/HIV and how state legislators can tackle these issues in their states and communities. Legislators from Utah and Rhode Island presented how they were able to gain passage of bills in their states to broaden prevention efforts and establish expedited partner therapy for STDs, and other legislators contributed their similar experiences from other states. Finally, legislators considered a list of the policy initiatives discussed, and indicated those they expect to pursue during the 2011-2012 legislative sessions.  

The meeting session was made possible through funding from the CDC’s HIV prevention program and STD prevention program and was presented in cooperation with the Partnership for Prevention’s National Chlamydia Coalition.



Health Reform and Health Disparities: the Challenges of STDs & HIV/AIDS

  • Kevin Cranston, MDiv, Director, Bureau of Infectious Diseases, Massachusetts Dept. of Public Health, Boston, Mass.
    Mr. Cranston has worked extensively with HIV/AIDS prevention programs in both the Departments of Public Health and the Department of Education in Massachusetts. Prior to state government, he was an adolescent HIV prevention specialist working with children and youth in Boston. Mr. Cranston was a visiting lecturer for four years at the Harvard Divinity School, and is the past Chair of the National Alliance of State and Territorial AIDS Directors (NASTAD). He also serves as a technical assistant through NASTAD’s Global Program to the AIDS control programs of Nigeria, Brazil, and South Africa.  contact: kevin.cranston@state.ma.us

  View the Presentation: "How Health Reform Can Help Reduce Disparities and the Challenges of STDs & HIV/AIDS" in PDF (without audio) or in QuickTime (with audio)

  • Donna Hubbard McCree, PhD, MPH, RPh, Associate Director for Health Equity, HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Ga.
    Dr. McCree is the newly appointed health equity director, and previously led a research project to evaluate approaches to lowering the risk of acquiring or transmitting HIV in specific populations. She has over twenty-eight years of experience in public health and pharmacy, and she has worked in academia, research, professional association management and retail and hospital pharmacy practice. Her current research focuses on HIV prevention and testing strategies for African American women and men as well as education of pharmacists to counsel patients about HIV and other STDs.  contact: zyr1@cdc.gov

View the Presentation: "Health Equity and HIV: Current Trends and Future Directions" in PDF (without audio) or in QuickTime (with audio)

  • David B. Johnson, STD Disparities Coordinator, STD Prevention, Centers for Disease Control and Prevention, Atlanta, Ga.

    Mr. Johnson’s work centers on identifying the social determinants that contribute to STD and HIV disparities among communities of color, including populations that have been marginalized due to sexual orientation. His work focuses on strengthening prevention research and developing programs that reduce disparities through partnerships with key community organizations and affected community leaders. Mr. Johnson has extensive teaching experience on HIV, TB, STD, and substance abuse prevention for public health professionals.  contact: dbj1@cdc.gov

View the Presentation: "Reducing Health Disparities in STDs and HIV/AIDS" in PDF (without audio) or QuickTime (with audio)


Provider and Community Initiatives to Reduce Health Disparities

  • Integrating Prevention into Medical Care for Youth: Gale Burstein, MD, MPH, FAAP, FSAHM, Associate Clinical Professor, University of Buffalo Pediatrics Associates, Buffalo, NY

    Dr. Burstein is Associate Clinical Professor, Division of Adolescent Medicine, SUNY Department of Pediatrics, and serves as medical director for the Erie County Department of Health’s Sexually Transmitted Diseases (STD) Clinic. She received her training in pediatrics, adolescent medicine and public health in New York, Ohio, and Maryland. She is board certified in Adolescent Medicine, is active with medical professional associations and has published extensively.  contact: gburstein@upa.chob.edu

View the Presentation: "Increasing Adolescent Sexual Health Services in Primary Care" in PDF (without audio) or in QuickTime (with audio)

  • Another Role for Medical Providers − Partner Therapy: David B. Johnson, STD Disparities Coordinator, Div. of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA.  (Biography Above).

View the Presentation: "Expedited Partner Therapy (EPT)/Patient Deliver Partner Therapy (PDPT)" in PDF (without audio) or in QuickTime (with audio)

  • Community-based Initiatives: Sara Gillen, V.P. for Prevention, Harlem United Community AIDS Center, New York, N.Y.

    Harlem United Community AIDS Center provides comprehensive HIV care, prevention and housing to clients regardless of race, socio-economic status or sexual orientation, reaching 10,000 people each year through innovative programs in Upper Manhattan and the Bronx. Harlem United has become a national model of comprehensive care in a community-based setting. Ms. Gillen has developed, implemented, and evaluated innovative HIV prevention programs including peer education training, substance abuse and harm reduction services for HIV-infected persons, and community-based outreach and prevention education for diverse groups. She has developed programs for groups ranging from Spanish-speaking women in East Harlem to substance users in single room occupancy hotels citywide, and she also conceived a prevention program for youth known as HOME (Helping Our Men Evolve).  contact: sgillen@harlemunited.org

View the Presentation: "Harlem United" in PDF (without audio) or in QuickTime (with audio)


State Legislation Discussion

Expedited Partner Therapy for Sexually Transmitted Diseases:

  • Rhode Island Senator Rhoda Perry, Chair, Health & Human Services Committee, Senate Bill 2806 (2010)

    Senator Perry has chaired the Senate Committee on Health and Human Services since 2006, and also sits on Senate Judiciary Committee, Joint Committee on Health Care Oversight, and Rhode Island Permanent Commission on Civic Education. Previously she was Deputy President Pro Tempore of the Senate for 10 years, Deputy Majority Leader and a member of the Commission to Study the Mentally Ill in the Criminal Justice System. She has supported legislation for nursing home quality care, health reform and insurance restructuring, lead paint safety and mental health parity. A retired health care administrator, she is currently employed by the City of Pawtucket as an ESL instructor.  contact:sen-perry@rilin.state.ri.us

  • Utah Representative Jennifer Seelig, House Bill 17 (2009)

    Representative Seelig has served in the Utah House of Representatives since 2006, and serves on the Political Subdivisions and Law Enforcement and Criminal Justice committees, as well as on the Executive Offices and Criminal Justice Appropriations Subcommittee. In 2010, she was elected to the leadership position of Minority Whip. She has worked for the Salt Lake City Council and Mayor’s office, as well as the Utah League of Cities and Towns. For the past several years, she has been employed by 1-800 CONTACTS as Associate Director of Governmental Relations, and is currently finishing a Ph.D. in political science at the University of Utah.  contact: jseelig@utah.gov

HIV/AIDS Prevention: Rhode Island Representative Eileen Naughton,H 6095 Sub. B (2007) included prenatal HIV screening as part of routine prenatal care and H 5415 Sub. A Amended (2009) to reduce vulnerability to HIV/AIDS transmission, protect persons with HIV from discrimination and ensure informed consent for testing

Representative Naughton was first elected to the Rhode Island General Assembly in 1992, and chairs the House Finance Committee’s Subcommittee on Human Services. She has been very involved in health policy, championing affordable and accessible health care. She has also been instrumental in developing many programs including a Birth Surveillance System, promoting prevention of HIV/AIDS, creating a vision-screening program for preschoolers and statewide reporting of pressure ulcers and hospital acquired infections, and stroke prevention and treatment. She was a Council of State Governments Toll Fellow in 2005, and serves on many health-related boards including NECON, the New England Coalition for Health Promotion and Disease Prevention. Ms. Naughton is a member of COPR, a federal advisory committee made up of public members who advise the National Institutes of Health (NIH) Director on issues related to public participation in NIH.  contact:  rep-naughton@rilin.state.ri.us


Policies Legislators are Likely to Pursue in 2011-2012 Legislative Sessions (listed in descending order of participants’ responses)

  1. Assist community-based providers of HIV prevention and testing in high-risk communities to include STD testing for chlamydia, gonorrhea and syphilis for at risk individuals.
  2. Prevention, screening, and treatment services in the justice system including juvenile detention, prisons and jails, and particularly before release into the community.
  3. Screening and treatment services in public programs for high-risk persons such as school-based clinics, homeless shelters and substance abuse and mental health programs.
  4. Media campaigns to encourage testing and prevention among groups disproportionately impacted by STDs and HIV/AIDS, particularly in African American and Latino communities.
  5. Insurance coverage for recommended screening, testing and treatment in all publically funded health plans including Medicaid, state employee plans and Title X funded programs.
  6. Evidence-based, age-appropriate school health education programs to reduce sexual risk behaviors among youth, including professional development for school instructors.
  7. Expedited partner therapy legislation or other initiative to encourage acceptance of EPT by medical providers.
  8. Medical provider education on expanded coverage for HIV and STD testing and counseling services, and how to provide services in a culturally and linguistically appropriate manner.
  9. Assist faith-based organizations working on health and wellness programs to provide HIV and STD testing and counseling services.