HIV and Syphilis Updates for Virginia Providers

Dear Colleague:

This letter provides updates on Virginia’s recent HIV trends, testing recommendations, prevention measures, care resources, and an update to Virginia’s syphilis screening recommendations.

HIV Trends, Testing Recommendations, and Informational Resources

Virginia’s HIV surveillance trends indicate increases in HIV diagnoses in 2024 among:

  • Youth (15–19 years – all races/ethnicities)
  • Hispanic/Latino populations (all age groups)

HIV infections are rebounding after the COVID-19 pandemic. Please help us ensure HIV testing and prevention recommendations are reaching all patients who may benefit.

Please be aware of CDC’s current HIV testing guidelines and recommendations. Some important recommendations from the CDC STI Treatment Guidelines include:

  • Screen all pregnant women, including those in labor with unknown HIV status.
  • Screen all adolescents and adults aged 15–65 years, screen younger adolescents and older adults at risk.
  • Test for HIV all persons seeking sexually transmitted infection (STI) evaluation who are not already known to have HIV infection. Testing should be routine/opt-out, regardless of reported risk.
  • Screen higher-risk groups (sexually active gay, bisexual, and other men who have sex with men) at least annually. Work collaboratively to assess their individual risk and the benefits of more frequent screening (every 3–6 months).
  • Discuss prevention options like HIV Pre-Exposure Prophylaxis (PrEP) and Comprehensive Harm Reduction (CHR) with all sexually active patients. Consider doxycycline as post-exposure prophylaxis (DoxyPEP) to prevent bacterial STIs that increase the risk of HIV.

If you have patients who test positive for HIV and need care resources, the Virginia MedicationAssistance Program (VA MAP) provides HIV/other medications, assistance with insurance premiums, or medication co-payments, for low-income patients who meet eligibility requirements. Please visit our website to view the Ryan White Part B: Unified Eligibility Assessment locations by region.

Updated Syphilis Screening Guidelines

Syphilis diagnoses in Virginia and across the nation have reached historic heights. Over the past decade, cases among women have risen significantly, leading to a sharp increase in babies born with congenital syphilis.

VDH recently revised its syphilis screening recommendations for sexually active people aged 15–44 based on recent Virginia data. The guidelines now use rates of all stages of syphilis among women 15–44, instead of only primary and secondary cases.

Why the Change?

Congenital syphilis can occur from infection at any stage during pregnancy. In Virginia, most women are diagnosed in later stages — only 21% of cases in 2024 were early stages. Including all stages gives a more accurate picture of high-risk areas and ensures counties with congenital syphilis cases are not overlooked.

What This Means for Providers:

  • Continue screening all pregnant women for syphilis at first trimester, third trimester, and delivery, regardless of location.
  • Using the updated screening recommendations map
    • In counties/cities where the rate of syphilis of all stages among women aged 15–44 years was greater than 4.6 per 100,000 in 2024, offer syphilis testing to all sexually active people aged 15–44 years.
    • In counties/cities where the rate of syphilis of all stages among women aged 15–44 years was less than or equal to 4.6 per 100,000 in 2024, providers should continue to assess individual risk factors to determine testing needs as outlined in the CDC screening guidelines.
  • Consider point-of-care (POC) syphilis testing in settings where immediate results can improve timely treatment and reduce congenital syphilis risk (emergency rooms, urgent care, correctional facilities, substance use treatment programs, comprehensive harm reduction sites, rural areas, shelters).
  • Discuss doxycycline for STI prevention (DoxyPEP) with male patients who have female sexual partners and have been previously diagnosed with HIV or a bacterial STI, or who report multiple sexual partners in the past year.
  • Refer to the Virginia Syphilis resource page for more information.

Thank you for your continued partnership in keeping Virginians healthy.

Sincerely,

B. Cameron Webb, MD, JD

State Health Commissioner

2024 Virginia Medical News MSV Member Magazine

The 2024 issue of the Virginia Medical News MSV Member Magazine is available here.

2024 Virginia Medical News magazine cover

Articles cover topics such as:

  • child mental health care in Virginia
  • medical students and mentorship
  • what to expect during the 2025 Virginia General Assembly session
  • physician and PA advocacy efforts

 

 

 

 

 

What Makes a Strong Healthcare Team?

Today’s healthcare teams face a growing need for interprofessional collaboration, creative problem solving, and impactful leadership training to drive organizational performance.

The healthcare work environment is changing every day. Across the board, healthcare providers are expected to do more – more paperwork, more reporting, more meetings, see more patients. At the same time, providers are feeling further isolated and less supported. The House of Medicine needs strong, dedicated leaders and effective healthcare teams more than ever.

The SYNC program is an innovative, team-based learning experience that teaches collaboration and leadership through hands-on problem solving. SYNC helps develop your leadership and teamwork skills by having you work on a capstone project to be presented at the end of the session. As a hospitalist, we chose to focus our SYNC Capstone on patients in the acute care setting. Our project focused on educating patients at high risk for stroke, in hopes of reinforcing compliance and ultimately decreasing their risk for stroke. Our team included physicians and nurses, and we reached out to pharmacists, social workers, and hospital leadership throughout the project. We initially sought to identify patients with new onset atrial fibrillation, however, upon reviewing the data, we realized the population size was too small and we had to widen our focus. As our project evolved, we faced challenges that forced us to make other changes. We reviewed social determinants of health, looking for patterns and areas where we could help patients. It forced us to look outside the lens of the hospital setting and more at proactive prevention rather than reactive treatment.

SYNC is facilitated by successful leaders who understand the necessary qualities for the entire healthcare team – communication, collaboration, and flexibility.

Communication is a key component in healthcare. Patients are relying on you to help them through some of the toughest times of their lives. In order to best serve your patients, you must have an open line of communication with your coworkers. Be open and honest with your team members. Check in with each other. Be present in conversations. The SYNC Capstone project creates a line for open and necessary communication with other members of the healthcare team.

Collaboration is necessary for success. This is the keystone of SYNC. If your team is not on the same wavelength or encouraged to share ideas, they will be less motivated to succeed. Being in an environment that encourages professional growth and allows ideas to flow freely ensures positive outcomes for patients. During our project, we learned from each other, each bringing different skills to the table.

Flexibility is required of all members of the healthcare team. By signing up for SYNC, participants are taking their first step into accepting and participating in the unplanned. The leadership role in the team is dynamic and changes depending on the needs and each other’s expertise.

The SYNC program teaches the foundation of effective interprofessional collaboration. Participants leave with a different understanding of what it means to be a part of the healthcare team. While our project started out small, we are working on expanding it to include more patients and involving new team members.

Denise G. Alcantara, M.D.
Sentara Hospital Medicine Physicians
SYNC Cohort 5

Participants have used SYNC to develop or build on programs that are critical for patients. Some of these programs include-

  • Stroke Education in High Risk Populations for Primary Prevention – Sentara Princess Anne Hospital – Cohort 5
    Project Goal: Implement a program identifying non-stroke patients admitted to hospital who are at high risk for stroke. Once identified, the focus will be to complete targeted stroke reduction education and follow the patient post acute-care.
  • Barriers to Breast Cancer Screening – Valley Health – Winchester Medical Center – Cohort 2
    Project Goal: Improve access and streamline delivery of breast cancer screening, identify barriers that make access difficult, and eliminate travel and distance between service delivery settings and target populations.
  • Improving Communication & Handoffs During Transitions of Care for ICU Patients – Centra Health – Inpatient Team – Cohort 1
    Project Goal: Decrease the amount of time until a patient is seen by a receiving physician after an ICU transfer, decrease rate of “bounce back” to ICU and eliminate unnecessary medications upon transfer.
  • Diabetes Prevention – A Public Health Collaborative – Mason and Partners Clinic & Prince William Health District – Cohort 1
    Project Goal: Identify pre-diabetic patients in the Mason and Partners Clinic and refer them to the lifestyle change program to improve overall health.  The project involved utilizing Community Health Workers in patient care and connecting patients to a medical home.

The House of Medicine is critical to keeping patients and communities healthy. With the changing landscape of healthcare and the added pressures of healthcare professionals, there has never been better time to sign up and become a part of SYNC.

If you have questions about SYNC conact Amy Swierczewski, Assistant Director of Intrastate Accreditation and MSVF Programs, at [email protected]