Ryan White Part B Supplemental - Virginia is a medium-sized southeastern state, consisting of 95 counties and 38 independent cities and ranked twelfth in population size. Its population estimate in 2025 of 8,880,107 accounted for 2.6% of the nation’s total population of over 342 million. In the Commonwealth of Virginia, the Virginia Department of Health (VDH) oversees the public health services of the Commonwealth and resources 39 health districts and 119 local health departments. The Office of Epidemiology houses the Division of Disease Prevention, which oversees the HIV Care Services unit that administers the Ryan White HIV/AIDS Program Part B (RWHAP B). The RWHAP B receives an annual formula award of approximately $8M, including the Emerging Communities funds the VDH allocates to 18 unique service providers and vendors to provide the allowable RWHAP services throughout the five Health Regions of the state. Virginia also receives almost $18M annually earmarked for the RWHAP B AIDS Drugs Assistance Program, ADAP, to provide medication access for the treatment of HIV and related illnesses for eligible clients. Funded services include 8 allowable core medical and support services, including medication access services through ADAP. Virginia’s system delivery system focuses on improving earlier linkage to care, retention in care, and viral suppression for low-income people with HIV (PWH). The Virginia RWHAP B provided nearly 7,933 PWH with core medical and support services for their HIV care and treatment during the grant year 2025. In grant year 2025, Virginia expended $43.5M total to meet the needs of the 7,933 PWH, including ADAP clients. Clients must demonstrate and maintain their eligibility for services. The network of providers includes community-based organizations (CBOs), AIDS services organizations, university and hospital health systems, free clinics, and federally qualified health centers (FQHCs). Further, Virginia maintains robust collaborations with other RWHAP cross-parts for service planning and allocations, including the RWHAP Part A planning bodies in the District of Columbia Emerging Metropolitan Area and Norfolk Transitional Grant Area. Demographic data show continued need for ongoing and increasing efforts in HIV care and treatment overall. Of the 851 people newly diagnosed with HIV in 2024, an estimated 23% received a late diagnosis. In 2024, there were 28,277 PWH in Virginia, representing 0.3% of the state’s population and approximately 2.4% of the nation’s total HIV cases. Blacks represent 56% of PWH (n=15,844). 71% of PWH are currently 40+ years (n=20,322) and 43% are 55+ years (n=12,116). Further, diagnoses of sexually transmitted infections (STIs) among PWH continue to be significant. Among those newly diagnosed with HIV between 2015 – 2024, 191 individuals were also diagnosed with hepatitis C virus (HCV) and 115 hepatitis B virus (HBV), including four acute cases of HBV. Data show stable trends in HBV and HCV coinfections from 2021 to 2024 (36, 36, 38, and 37 cases, respectively). Stable trends indicate a need for more targeted prevention efforts to reduce comorbidity and connect those in need of care. Historically, Virginia has had ADAP pharmaceutical rebates to fund additional RWHAP B core medical and support services. The landscape for generating pharmaceutical rebates is changing and impacting the ability to maintain the program’s responsiveness to PWH’s needs. The goal of the supplemental funds is to maintain the comprehensive system of HIV care and treatment, specifically as it relates to medication assistance, made available through the RWHAP Part B program in Virginia. The supplemental funding’s impact will be improved health outcomes along the HIV Care Continuum for Ryan White eligible Virginians and supporting other care and treatment goals toward Virginia becoming the healthiest state in the nation.
