Category: DDP E-bulletin

Hepatitis Awareness Month is observed each May. Hepatitis Testing Day is May 19, annually. DDP will have a blog about Hepatitis Awareness Month and Hepatitis Testing Day on our homepage and post related social media content on our Facebook page throughout May.

Follow our Facebook and visit our homepage to share our content on your page for the observance(s).

For questions about awareness day resources, please contact Chris Barnett, DDP Public Relations Coordinator, at christopher.barnett@vdh.virginia.gov.

The National Clinician Consultation Center (NCCC) has expanded their services to include weekend hours. The PEPline will now be available on Saturdays and Sundays from 1 p.m. until 5 p.m., not including holidays.

The PEPline number is 844-ASK-NCCC (844-275-6222).

For more information about the NCCC PEPline and the services that they provide, visit the NCCC PEPline website.

Medetomidine is a very strong veterinary medicine. It is used as a sedative and pain killer for large animals, similar to xylazine but much stronger. The drug is increasingly found in the United States (U.S.) street drug supply mixed with fentanyl. It causes severe sedation, extremely low heart rate and low blood pressure in humans. Often called, "rhino tranq," or “Dex,” it is not approved for human use and is causing severe, long-lasting withdrawal symptoms, requiring urgent hospital care.

Rapid withdrawal from medetomidine can cause severe symptoms, including dangerously high heart rate and blood pressure, uncontrollable vomiting, tremors, and hallucinations, often requiring intensive care stays. As of early 2026, it is rapidly replacing xylazine in the street drug supply, particularly in the northeastern U.S., with up to 87% of drug samples in certain cities containing the sedative.

Medetomidine test strips are available at Comprehensive Harm Reduction (CHR) programs and at some local health departments.

For questions, please contact Bruce Taylor, Drug User Health Coordinator, at bruce.taylor@vdh.virginia.gov.

The second annual HIV and Hepatitis Prevention Summit took place on March 31 and April 1, 2026, at the Virginia Crossings Conference Center in Richmond, Virginia. The event brought together 83 participants representing cross‑sector HIV prevention and care partners, viral hepatitis stakeholders, and individuals with lived experience. Attendees included:

• • medical providers
  • care linkage staff
  • harm reductionists
  • testing and prevention specialists
  • local health department teams
  • pharmacists

Over the two‑day gathering, participants shared strategies for HIV prevention, care coordination, and hepatitis C elimination; explored new opportunities for collaboration; and highlighted ongoing efforts across the Commonwealth.

VDH recently released a clinician letter with HIV and syphilis updates for Virginia providers.

While the total number of new HIV diagnoses in 2024 was lower than 2023, there are increasing trends among youth and Hispanic/Latino populations. These trends should be known by providers, community partners, and health districts to better advise testing, prevention, and care efforts.

VDH updated the Virginia syphilis screening recommendations for reproductive-aged sexually active people (15-44 years).  The guidelines use the 2024 rate of syphilis of all stages among women aged 15-44 to identify counties with “high syphilis rates”

• • In counties where this rate is high – above 4.6 cases/100,000 population – screening for syphilis is recommended for all sexually active people ages 15-44
  • In counties where this rate is below 4.6 cases/100,000 population, providers should continue to assess individual risk factors to determine testing needs as outlined in the CDC Screening Guidelines

Why we made this change:

• • The Virginia syphilis screening guidelines aim to reduce syphilis and congenital syphilis rates. Congenital syphilis cases are at historic highs in Virginia and nationwide. Cases of syphilis among women continue to increase.
  • Congenital syphilis cases can result from maternal infection at any stage of syphilis during pregnancy, not just primary or secondary stages.
  • Prior to this change, the rate was limited to primary and secondary syphilis cases. A majority (79%) of Virginia women are diagnosed in later stages; only 21% were diagnosed in the primary and secondary stages in 2024.
  • Expanding the guidelines to include the rate of all stages of syphilis ensures a more accurate representation of counties with high syphilis rates among

DDP is finalizing plans for digital advertisements that will begin in April/May and run for six weeks. These ads will focus on HIV and STD testing, syphilis/congenital syphilis, PrEP, and DoxyPEP. They will be delivered to audiences and geographic areas with higher HIV and STD incidence.

Local health departments and community partners may see an increase in traffic to their programs as a result of this messaging.

For any questions regarding DDP marketing initiatives, please contact Chris Barnett, DDP Public Relations Coordinator, at christopher.barnett@vdh.virginia.gov.

DDP staff is working on edits to the Virginia Integrated HIV Services Plan.  We are currently in the planning stages of 2027-2031 version of the plan.  The current plan objectives and information can be found on the DDP plan webpage.

A Virginia Integrated Services Plan Town Hall was held on March 4, 2026.  During this meeting staff discussed the current plan, talked about the 2027-2031 plan, and asked consumers and other stakeholders what needs there were around HIV prevention and care in the Commonwealth.  The recording from the town hall can be found online.

VDH staff will hold additional meetings to discuss regional needs as they continue to shape the Virginia Integrated HIV Services Plan 2027-2031.

National Women and Girl’s HIV/AIDS Awareness Day (NWGHAAD) is on March 10, 2026. This year marks the 20th annual observance of NWGHAAD.

You can help raise awareness of this observance by:

• • Using messaging and graphics from the following organizations:
    • Womenshealth.gov
    • HIV.gov
    • Greaterthan.org
  • Sharing VDH & DDP social media posts
  • Using the hashtag #NWGHAAD on any relevant posts you create of your own
  • Access information on HIV and women and hold HIV outreach and testing events for women for NWGHAAD

Learn more about NWGHAAD on the WomensHealth.gov NWGHAAD page.

Most staff and community partners are aware that Kimberly Scott has announced her retirement and will have went out on leave prior to her retirement date prior to this newsletter being distributed. Her official retirement announcement is included in this month’s edition.

While the director position for HIV Care Services is being recruited, please note that the following staff will be covering:

• • Allison Green, Senior Program Advisor to Ryan White Part B (RWPB) will be the Acting Director for HIV Care Services. She can be reached at allison.green@vdh.virginia.gov or 804-864-8065
  • Jonathan Albright, Grants Manager for RWBPB will serve as acting Program Director and Primary Investigator for RWPB. He can be reached at jonathan.albright@vdh.virginia.gov or 804-380-6445.
  • As always, please continue to contact Kimberly Eley, Assistant Director for Medication Access, for any VA MAP needs. She can be reached at kimberly.eley@vdh.virginia.gov or 804-864-8018.

The UK Health Security Agency (UKHSA) identified a new recombinant mpox virus in English in December 2025 in an individual who had recently traveled to Asia. Genomic sequencing of the virus showed that the mpox genome contained elements of both clade Ib and clade IIb mpox.

This development is not surprising given that viruses evolve and highlights the importance of continued genomic surveillance.

Read the full statement from UKHSA.

A notice from the CDC went out to public health laboratories updating guidance for monkeypox virus testing protocol. People who have been exposed to mpox or who are at risk of exposure should receive the mpox vaccine.

In Virginia, 36 mpox cases were reported in 2025, compared to 27 in 2024, and 12 in 2023. Visit the VDH mpox website for data and other resources.

National Black HIV/AIDS Awareness Day is observed on February 7 each year. Graphics and materials for NBHAAD can be found on the following website for your agency:

• • National Institutes of Health
  • GreaterThan.org

DDP will have a social media post(s) and blog write-up for the observance next month. You can find DDP blog postings at www.vdh.virginia.gov/disease-prevention. You can also follow us on our Facebook page at www.facebook.com/diseasepreventionhotline.

The following is a community submission from Juan, a member of the Virginia Quality of Care Consumer Advisory Committee (VACAC), celebrating Kimberly's retirement, career, and contributions to the VACAC.

VDH is hosting a town hall for the general public and those with vested interest in HIV care and treatment services to discuss the impact of HIV in their communities. This includes people with lived experiences, community advocates, medical and non-medical care providers, etc.

The town hall will be held virtually on Wednesday, January 28, 2026, from 6 p.m. to 8 p.m. There will also be a call-in option for those without computer access. To register for the town hall, please sign up through REDCap.

For more information, questions, or if you need help registering, please contact Ashley Yocum, Care Services Planner, at ashley.yocum@vdh.virginia.gov or (804) 864-7621.

The state contract with Global Protection has still not been resolved. However, VDH can fulfill condom orders for agencies based on current supply. DDP's current condom inventory is actively changing. Due to this, DDP has removed the order form from the community partners’ webpage and asks that you email the Disease Prevention Hotline at hiv-stdhotline@vdh.virginia.gov for the most updated form.

As a reminder, community-based organizations and local health districts are eligible to participate in the DDP Condom Distribution Program. Organizations that participate in the program may order up to 100,000 condoms each year. Agencies with multiple locations/sites may be approved to order more.

Please contact the Disease Prevention Hotline if you are interested in becoming a distribution site, for the most current order form, or for general questions about the program, at hiv-stdhotline@vdh.virginia.gov.

The MidAtlantic AETC continues to offer regular training courses. Through December 2025 and January 2026 there are numerous courses that are required for staff providing rapid HIV testing in Virginia (HIV Facts and Fundamentals).

Search for training courses near you for you or your staff.

The AETC has also created pocket guides in electronic format available for viewing and download. Some of the topics include:

• • Mental Health and HIV
  • Key Concepts in Motivational Interviewing
  • Lessons in Patient Assessment & Engagement
  • Non-Occupational Post-Exposure Prophylaxis (nPEP)
  • HIV Case Finding for Persons with Substance Use Disorder

Access the more than ten clinical pocket guides on the AETC website.

Each year DDP sends out DDP Security and Confidentiality Policies and Procedures for all staff and agencies that handle, use, enter, or analyze DDP confidential paper records, electronic records, or data. DDP staff have an internal process to acknowledge these policies and procedures.

Non-DDP staff have a separate process. Non-DDP staff include external contractors, service providers, and data recipients. The non-DDP staff policies and procedures can be found on the community partners webpage.

These policies and procedures have been sent to non-DDP responsible parties as of December 10, 2025. Anyone who received these policies should review them and complete the REDCap verification form by December 31, 2025. All other non-DDP staff should sign the Verification of Receipt form by December 31, 2025, and retain the forms on site for review by your DDP contract monitor at your annual site visit.

For questions regarding the process for non-DDP staff to complete this REDCap form, or if you believe you received the document by mistake, please contact Brianna Carey, HIV Counseling, Testing, & Referral Program Coordinator, at brianna.carey@vdh.virginia.gov.

Note: if you are a DDP staff member and have not received an email requesting that you review the policies and procedures, please contact Christina Martone, HIV Network Detection and Response Program Coordinator, at christina.martone@vdh.virginia.gov.

The National Coalition of STD Directors (NCSD) has released their Policy Aid: Innovations in Syphilis Policy Playbook. As one solution to the increased need for solutions to syphilis and congenital syphilis cases, NCSD released this document. It examines six syphilis prevention policy strategies that were implemented by health departments across the U.S. Key implementation steps and considerations for replication and adaptation are included in the document. Results, lessons learned, and other considerations are also included.

View the full PDF from NCSD to learn more. For questions related to the policy aid, contact NCSD’s policy team at policyteam@NCSDDC.org.

The HIV Cluster Detection and Response (CDR) program is changing its name to HIV Network Detection and Response (NDR). Feedback from our Community HIV Planning Group and discussions with other jurisdictions who have made this transition confirm the term ‘network’ is less stigmatizing. The name change will also decrease past confusion that an identified cluster indicates an outbreak.

Please refer to the NDR webpage for additional information about this program. For questions, please contact Garrett Shields, NDR Program Manager, at garrett.shields@vdh.virginia.gov.

The National Coalition of STD Directors (NCSD) is offering a training, Sexually Transmitted Infections and Diseases in Urgent Care Centers. CEUs are available and the training is being offered at no cost during November.

Recognizing that more patients are turning to urgent care centers for treatment of potential STIs, NCSD organized this training. The course will educate providers to identify and treat the most commonly encountered sexually transmitted infections in the urgent care setting. At course completion, .5 ANCC credits are earned.

Share this opportunity with any providers in your network who work in urgent care and other providers who may be interested.

Providers should visit the NCSD Learning Center to register for the course. They must have an account to register. Creating an account in the NCSD Learning Center is free if they do not already have one.

The STD/HIV Prevention Training Center, John Hopkins Medicine is offering a “3 Day STI Overview”. The 3-day course runs December 9 through December 11, 2025, and is available to all health care providers and health care workers in the District of Columbia and the states of Delaware, Kentucky, Maryland, Pennsylvania, Tennessee, Virginia, and West Virginia.

Topics covered in the course include:

• • STI surveillance data
  • Taking a sexual history/patient communication
  • STI screening guidelines
  • The role of disease intervention specialists
  • Vaginitis
  • Status neutral care
  • GC/CT/Mgen
  • HPV/HSV/mpox
  • Syphilis
  • Viral hepatitis
  • And more!

Credit is available for the course. For more information, or to register, visit the training center’s website.

In response to increases in syphilis among pregnant women and congenital syphilis cases, the National STD Curriculum (NSTCD) released additional resources. The NSTCD is a free educational website from the University of Washington STD Prevention Center. New resources include:

• • A National STD Curriculum Lesson
  • Question Bank Topic Reviews

Visit www.std.uw.edu for additional educational resources from NSTCD.

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!

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!

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.

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.

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.

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.

The HIV Epidemiology Profile Updates for 2024 have been added to the DDP Data and Reports page.

Updates are available for:

• • People with HIV
  • New HIV Diagnoses

Contact Lauren Maxwell with any questions about the new updates at L.maxwell@vdh.virginia.gov.

Bulk condom orders are currently on hold while the Department of General Services negotiates with Global Protection to renew its contract with the Commonwealth of Virginia. This situation has extended beyond initial expectations, resulting in temporary shortages of several brands, including non-latex condom options, lubricant, and Trojan Magnum condoms.

DDP is optimistic about resuming orders from Global Protection soon. In the meantime, we encourage you to place your order with hiv-stdhotline@vdh.virginia.gov using the updated VDH Condom Order form, which is available on our website. This form will be continuously updated to reflect our inventory. We hope to clear out our current stock during this hold, streamlining future orders directly through Global Protection.  Therefore, there is no current hard limit on condom orders. However, orders may be adjusted depending on inventory.

We appreciate your understanding and patience during this period, and we will keep you updated as the situation changes. If you have any questions or need assistance, please reach out to the Disease Prevention Hotline at hiv-stdhotline@vdh.virginia.gov.

The HIV and Hepatitis Testing Team Administrative Portal is DDP’s central resource for agencies to manage HIV and Hepatitis testing needs. Community-based organizations, local health departments, and health centers can use the portal to:

• • Request:
    • Testing supplies (such as HIV and HCV test kits and/or controls)
    • CTR forms
    • Tyvek envelopes
    • Technical assistance
  • Report problems with test kits or controls
  • Notify DDP about expiring or test kit controls
  • And more!

To access the Administrative Portal, visit: https://redcap.vdh.virginia.gov/redcap/surveys/?s=MYEJ39XTY9. The link to the portal is also available on the DDP Community Partners page under the General Partner Agency Resources expandable tab.