Wednesday, September 27, 2023
9/27/2023
Background: San Francisco (SF) is profoundly impacted by the hepatitis C virus (HCV), with approximately 2.5% of the general population seropositive for HCV as of 2015, and a chronic rate of hepatitis B virus (HBV) that is 3 times that of the statewide rate in CA. Purpose: Our purpose in responding to RFA-PS21-2103 is to respond to our continuing challenges with viral hepatitis in SF by 1) increasing analysis and reporting of chronic and perinatal HCV and chronic HBV infection, undetectable HCV RNA, and HBV DNA laboratory results; 2) improving our ability to analyze and publicly disseminate information about viral hepatitis in SF on an annual basis; and 3) enhancing the effectiveness of existing viral hepatitis prevention activities by leveraging our longstanding collaborations with community providers and coalitions to increase access to HBV and HCV testing in high-impact settings. Focus: As successful as SF has been in implementing cutting-edge, evidence-based interventions to work toward elimination of HBV and HCV, SFDPH data reveals that Blacks/African Americans, people who are unhoused, baby boomers, men who have sex with men (MSM), trans women, and people who inject drugs (PWID) are likely to be infected with HCV or HBV. For Components I and II of this proposal, our focus continues to be on these highprevalence populations, utilizing a health equity approach to address identified health disparities and their underlying social determinants, including homelessness and incarceration. Staffing: The Principal Investigator for both components will be Tomás Aragón, MD, DrPH, the Health Officer of SF. He will be accountable for overall planning, implementation, monitoring, and reporting. Component I will be overseen by Juliet Stoltey, MD, Director of Communicable Disease Control and Prevention (CDCP), with the support of Melissa Sanchez, PhD, Director of Viral Hepatitis Surveillance, and a to-be-hired Epidemiologist II who will coordinate the day-to-day activities. Component II will be overseen by Katie Burk, MPH, the Viral Hepatitis Coordinator, who will be responsible for overseeing the planning and implementation of HBV elimination activities within SFDPH, in partnership with Richard So, MPH, the Executive Director of SF Hep B Free – Bay Area, and a to-be-hired End Hep C SF Strategic Director, who oversee the planning and implementation of HCV elimination activities. Component I Summary of Strategies and Activities: 1) Review existing outbreak plans in other US jurisdictions and formalize a set of outbreak plans for HAV, HBV, and HCV in SF; 2) Begin to collect and analyze results of negative HCV RNA tests; and 3) Build a system for regular, public reporting of our viral hepatitis data for HAV, HBV, and HCV: with these funds we will start releasing annual public reports of HAV, HBV, and HCV in SF, similar to what is currently done with other diseases in SF. Component II Summary of Strategies and Activities: 1) Support viral hepatitis elimination planning by hiring an End Hep C SF Strategic director to support existing HCV elimination activities, therefore freeing up the city's Viral Hepatitis Coordinator to coordinate with SF Hep B Free – Bay Area and engage in formal elimination planning for HBV in SF; 2) Conduct a needs assessment for laboratories and major health systems in SF to increase routine HCV and HBV testing in those settings (including reflex HCV testing); 3) Expand provider capacity to treat HCV and/or HBV, including by enhancing existing training efforts, improving guidance, and boosting dissemination of materials regarding evidence-based practices for access to HCV treatment and prevention; 4) Partner with the UCSF DeLIVER Care van, SSPs, and mobile Health Access Points in the Bayview/Hunters Point districts to increase access to HCV and HBV testing and referral in high-impact settings, along with post-test counseling and referral to treatment or prevention; and 5) Establish HAV and HBV vaccine delivery teams.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
