Unexpected Federal Funding Received for HIV Medical Monitoring Project (MMP)

On September 30, 2025, DDP received a surprising notice of award (NoA) for the HIV Medical Monitoring Project (MMP). Prior funding for MMP ended on May 31, 2025, and we were told the grant would not be renewed. Therefore, DDP ended the program and MMP staff were unfortunately laid off. Due to the unexpected nature of this new award, the back date of the project period to 6/1/25, and current federal government shut down, the remainder of the first year, or grant year 1, will be used to recruit staff and re-establish the program. DDP is awaiting further guidance from CDC, which will occur after the resolution of the federal government shutdown.

DIS Recognition Day

DIS (Disease Intervention Specialist) Recognition Day was Friday, October 3. This special day is observed nationally each year to promote the special work that our DIS do within our communities. The National Coalition for STD Directors, VDH, and DDP had blog postings for the occasion and promoted or shared posts and graphics on social media.

Read more about the special work that Virginia DIS do on our blog posting. While DIS Recognition Day may have passed, we thank our Virginia DIS for their hard work and dedication every day!

Exciting News! The Resource Connections Website is Getting a Makeover

The Resource Connections website is being relaunched with a fresh new look and a new name — The RC: Resource Connections — on the Connect 211 platform! Along with the updated design, the site will feature a new logo and URL.

What to Expect During the Transition:

- Automatic Redirect: For a limited time, the original URL will automatically redirect to the new one, giving you time to get familiar with the updated address.
- Seamless Content Migration: All existing information from the original platform will be transferred to Connect 211.
- Funded Agency Access Restored in early 2026: If you are a funded agency, you’ll be able to update your profile and other relevant information once that functionality is restored in early 2026.

The DDP team is working diligently to ensure a smooth and timely transition with minimal disruption to your access to the valuable resources listed in The RC: Resource Connections directory.

Stay tuned — more details will be shared as they become available, and DDP will announce the official relaunch date soon!

Opt-Out DoxyPEP at Select PrEP Clinics

DoxyPEP will now be offered as an "opt-out" service for appropriate PrEP (pre-exposure prophylaxis) clients at local health departments across the state. Roll out of the initiative will happen over the next several months at select sites.

DoxyPEP is the use of doxycycline to prevent syphilis, chlamydia, and gonorrhea after a potential exposure. It is a single dose of 200mg taken within 24-72 hours of unprotected sex and is highly effective in reducing bacterial STIs. The Centers for Disease Control recommends it for gay, bisexual, and other men who have sex with men and transgender women with a history of at least one bacterial STI in the last 12 months.

Which Cardiovascular Disease Risk Calculator Is Best in HIV Care? Global Assessment Leaves More Questions Than Answers

Researchers compared three cardiovascular disease (CVD) risk calculators: Pooled Cohort Equations (PCE), PREVENT, and SCORE2. They used data from the REPRIEVE trial involving 7,757 people with HIV but no prior atherosclerotic cardiovascular disease (ASCVD). They found that the calculators often gave very different risk assessments for the same patients: PCE classified the most as statin eligible, PREVENT the fewest, and SCORE2 was in between. Despite this, the number needed to treat (NNT5) estimates were similar across groups.

The analysis highlights that PCE, widely used in U.S. guidelines, tends to underestimate cardiovascular risk in people with HIV because it doesn’t account for HIV-related factors like chronic inflammation and antiretroviral therapy. There is no universally validated risk tool for people with HIV yet. The findings suggest clinicians should use these calculators cautiously and encourage more open, individualized discussions about statin therapy rather than relying solely on risk scores.

Clinicians in the U.S. have generally relied on the PCE to estimate 10-year ASCVD risk because it’s embedded in national guidelines and electronic health record systems. It’s easy to use, and it’s what insurers, cardiology colleagues, and primary care guidelines reference.

This study doesn’t demand an overnight change in our clinical practice. However, the findings should encourage clinicians to have more proactive conversations about statins with their patients, not push statins on everyone, but to make sure risk is discussed openly and contextually.

Further information about this review or about the primary authors of the study can be found on the BodyPro.com or contact Safere Diawara at safere.diawara@vdh.virginia.gov.

Patient-Centered HIV Care Is Key to Adherence and Viral Suppression in Women of Color

A cross-sectional study was conducted with 542 women of color living with HIV in Miami-Dade County between June 2021 and March 2022. It found that patient-centered, culturally sensitive care, especially provider behaviors such as respect, listening, involvement in decision-making, and spending adequate time with patients, is key to promoting antiretroviral therapy (ART) adherence and viral suppression. The study population, enrolled in Ryan White Program clinics with strong support systems, had a high viral suppression rate (~91%), much higher than the national average.

The findings highlight that small interpersonal actions, when supported by robust systems that address barriers, can greatly impact clinical outcomes. Different racial and ethnic groups emphasized different aspects of the patient-provider relationship, underscoring the importance of culturally tailored care rather than one-size-fits-all approach. This study confirms that compassionate and respectful care, the often overlooked “soft” skills of clinical practice, are critical to long-term ART success in women of color with HIV.

Patient involvement in decision-making was especially important for some groups, reflecting the diversity within racial and ethnic populations. Overall, this research reminds us that culturally informed care that acknowledges these nuances is essential for effective HIV treatment.

Find more information about this review and the primary authors of this study at the BodyPro.com or by contacting Safere Diawara at safere.diawara@vdh.virginia.gov.

Study Finds that ART Is Not a Guaranteed Lifesaver for Pediatric Patients with HIV

A systematic review and meta-analysis of 84 studies (2000–2020) examined HIV-related mortality in children and young adolescents (ages 0–15) receiving antiretroviral therapy (ART). The analysis found that mortality risk is highest in the early period after ART initiation and is strongly influenced by age and immune status at the start of treatment, particularly low CD4 counts.

While ART is essential, it is not always sufficient to prevent early deaths. Early diagnosis, rapid treatment initiation, prophylaxis, management of opportunistic infections, and strong inpatient and outpatient support during the first weeks to months of care are critical. These factors help explain why early deaths persist even as overall pediatric HIV mortality declines.

The findings reaffirm that delayed treatment leads to poorer outcomes and highlights the urgent global need to strengthen early pediatric HIV diagnosis and care. Although key interventions are known, achieving equitable outcomes will require addressing persistent health system and social barriers that hinder timely access and sustained care for children living with HIV worldwide.

For more information on this review or about the authors of this study, visit the BodyPro.com or contact Safere Diawara at safere.diawara@vdh.virginia.gov.

Personnel Announcements

Retirement: Elaine Martin

Elaine Martin’s last working day with DDP/VDH was Tuesday, September 30. She is on leave until her official retirement date, January 1, 2026. Elaine has served as the Director of DDP since 2022. In total, Elaine gave 38 years of service to the Agency and our division; many of those years were in a leadership capacity. Her career began at the height of the HIV/AIDS epidemic in the United States. Her expertise and contributions to HIV/AIDS in public health in Virginia (in collaboration with colleagues) were many, including creating programs such as:

- HIV self-testing
- Comprehensive Harm Reduction (CHR) in Virginia
- HIV/hepatitis pharmacy testing
- Pre-exposure prophylaxis (PrEP) for HIV
- Comprehensive HIV/AIDS Resources and Linkages for Individuals Experiencing Incarceration (CHARLII)

Many of these programs were innovative at the time and have since become successful staples in the eyes of federal agencies and other states and jurisdictions. For instance, the Centers for Disease Control and Prevention eventually developed their own HIV self-test kit program and now encourages pharmacy testing of their funded state health departments!

We wish Elaine the best in her retirement as she enjoys traveling and relaxing with her adoring pets. Happy retirement, Elaine, you will be missed!

DDP E-Bulletin: October 2025