Background: Laws and policies affect whether and how people impacted by HIV, viral hepatitis, STIs, and TB can access disease prevention and other health services. Inequitable application of laws and policies, particularly those negatively impacting populations most at risk for HIV, viral hepatitis, STIs, and TB, may exacerbate health disparities. Tracking pending state legislation allows for rapid identification of real-time changes, trends, and potential health impacts to inform comprehensive, evidence-based responses. Paring legislation tracking with the provision of timely and tailored technical assistance (TA) enables practitioners to leverage policy as a public health intervention through a syndemic approach.
Methods: Utilizing FiscalNote software, our team is tracking legislation in active sessions across all fifty states and Washington DC. We utilized nine search terms to ensure precision and consistency. Each identified bill was coded based on disease, strategic focus areas of a syndemic approach to HIV, viral hepatitis, STI, and TB prevention strategy, and content areas. After coding, we developed reports to highlight trends, passed legislation, and focus areas.
Results: 170 bills in 2023-2024 legislative sessions were identified and tracked. Trends identified as strategic focus areas include: syringe service programs (SSP), congenital syphilis, HIV criminalization/decriminalization, and PrEP/PEP access via pharmacies. Our team has received a number of SSP-related requests related to bills restricting the establishment and/or operation of SSPs that have passed in active state legislative sessions. Recently enacted laws that restrict SSPs forecast worrying trends around perception of SSPs and may potentially impact previously authorized SSPs.
Conclusion: Tracking legislation in specific disease areas provides an opportunity to identify and explore trends in real-time and inform evidence-based practice across the public health ecosystem. Syringe service programs are a topical example that explores the direct application of policy tracking with TA based on a syndemic approach to public health.
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