1. Anne Rhodes, Director, HIV Surveillance Unit Division of Disease Prevention Office of Epidemiology HIV Program Integration

2. Funding/Changing Grant Requirements SPNS Systems Linkages – 4 year grant from HRSA received in 2011 to improve HIV linkage, retention, and viral suppression using state- designed interventions CAPUS – 3 year grant from CDC received in 2012 to increase HIV diagnosis rates for racial and ethnic minorities and increase linkage, retention and re-engagement in care for racial/ethnic minorities living with HIV

3. Division of Disease Prevention HIV PreventionHIV Care HIV Surveillance STD Operations (includes DIS) TB/Newcomer Health

4. How to Define Care for HIV CD4 Count Viral Load Evidence of HIV Medication Medical Visit Care Markers Ryan White ADAP VACRS eHARS ELR MMP MedicaidHIV Testing CAPUS

5. Virginia’s HIV Continuum of Care: Before and After Care Markers Database Data derived from HIV Surveillance, VACRS, ADAP data; Division of Disease Prevention, Virginia Department of Health; February/March 2014 N=926

6. Continuum of Care for Ryan White Clients, 2013 All RW clients living with HIV in Virginia as of 2013 RW clients diagnosed with HIV in 2013 (N=421) 7,083

7. Persons Living with HIV as of December 31, 2012 With A Care Marker in 2012 *11,082 had a care marker: medical visit, CD4 count, viral load, or ART prescription in 2012; 6 missing and 9 out of state at last locality

8. Surveillance Data in ADAP Needs assessment/program planning Complete missing data (demographics, labs) Quality Indicators, including retention in care, viral suppression, linkage to care rates Unmet need

9. CAPUS Test Sites Map

11. MMP and Care Markers Used Care Markers to assist with location of persons in MMP sample and utilized patient navigators at sites conducting MMP to assist in finding persons for MMP interviews Piloted at 2 sites in early 2014, plan to expand to all sites in upcoming cycle of MMP

12. Re-Engagement in Care Pilot Developed List of those diagnosed in: – 2013 without a care marker – 2009-2013 without a care marker Piloting List with 3 local health departments and DIS Have internal protocol for reviewing lists prior to sending to DIS

13. CDC Consultation (July 2014) Cases in Ryan White and not in Surveillance Who can follow up when someone falls out of care? Consumer Input – want testing sites to do follow up Reviewed Ethical Framework for Data to Care Activities