The Division of Disease Prevention (DDP) within the Office of Epidemiology, at the Virginia Department of Health, will utilize CDC-RFA-PS-24-0047 to implement a comprehensive and integrated HIV surveillance and prevention program that will: 1) prevent new infections; 2) improve health outcomes for people with HIV (PWH) achieve and sustain viral suppression; and 3) reduce related health disparities per national prevention goals, HIV Care Continuum, and CDC’s High Impact Prevention approach. Improvement in completeness and timeliness of HIV surveillance data; increased use of interventional surveillance; increased HIV testing and uptake of pre-exposure prophylaxis (PrEP); and improved linkage, retention, and adherence interventions that contribute to viral suppression will be central to achieving PS-24-0047 outcomes.
Strategy 1:
DDP plans to continue its “No Wrong Door” approach to increase the number of individuals who are tested for HIV and receive diagnosis and linkage to appropriate services as early as possible. DDP will continue to provide testing through partnered organizations and expand distribution of HIV self-test kits, prioritizing disproportionately stigmatized and /or geographically isolated clients.
Strategy 2:
DDP will maximize existing activities to improve referral, linkage, and retention in care among PWH to achieve viral suppression through a trauma-informed lens. DDP will utilize cross-unit collaboration and blended funding to ensure both Ryan White eligible and those not eligible for Ryan White obtain essential and supportive services.
Strategy 3:
DDP will leverage existing programs and infrastructure to expand its services by adding new sites to its existing networks for PrEP/post-exposure prophylaxis (PEP), comprehensive harm reduction (CHR) services, and condom distribution programs statewide. DDP will build on its existing status-neutral service navigation (SNSN) referrals and linkages processes to increase access to PrEP/PEP and other social services for persons vulnerable to HIV. Additionally, DDP will monitor perinatal HIV to prevent the transmission of HIV from parent to child.
Strategy 4:
DDP will identify, investigate, prioritize, and rapidly respond to HIV transmission clusters and outbreaks and maintain The Virginia Cluster and Outbreak Detection and Response Plan. DDP will implement individual, network, and systems-level intervention activities in networks with active transmission. DDP will conduct annual community engagement activities to educate community members on CDR and to gather feedback and input on the DDP CDR program.
Strategy 5:
DDP will utilize quality assurance mechanisms including various HIV surveillance reports and continuously improve upon other infrastructures like the laboratory management system (LMS), to reduce duplicate reporting and improve manual review of laboratory documents.
Strategy 6:
DDP will focus on engaging priority populations through existing partnerships within the Virginia Community HIV Planning Group (CHPG), Community Advancement Project, Sisters Promoting H.O.P.E., Virginia Hepatitis Coalition, and Virginia Quality of Care Consumer Advisory Committee. DDP staff and leadership will implement the 2022-2026 Virginia Integrated HIV Prevention and Care Services Plan (The Plan). Data, including HIV and STI data from the Virginia Electronic Diseases Surveillance System (VEDSS); HIV data from eHARS; the Epidemiological Snapshot of the burden of HIV and other STIs in Virginia; the HIV Epidemiological Profile; and multiple state and local needs assessments, inclusive of voices of PWH, will inform The Plan.