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Tag: HIV outbreak

  • West Virginia HIV Outbreak Is A "Nightmare"

    West Virginia HIV Outbreak Is A "Nightmare"

    Approximately 74 new cases of HIV have been reported in Cabell County since January 2018.

    Despite having many public health policies in place to prevent the spread of disease—including a needle exchange program—one West Virginia county is seeing an alarming spike in new HIV transmissions largely brought about by drug users sharing needles. 

    Seventy-four new cases of HIV have been reported in Cabell County since January 2018, according to Politico. 

    “The ground is fertile,” Judith Feinberg, a professor of behavioral medicine and infectious diseases at West Virginia University, told Politico. “This is the nightmare everyone is worried about.”

    Harm Reduction Efforts

    In 2015, Cabell County started a needle exchange program. It also has drug treatment programs, STI testing and expanded access to PrEP, a treatment regimen that can reduce the risk of contracting HIV if taken daily. All of this is unusual, especially for a rural county. The fact that HIV has taken hold despite these efforts make the outbreak especially concerning. 

    Michael Kilkenny, physician director at Cabell’s health department, said he can’t explain why HIV cases are increasing, despite the county’s efforts. “I have no answer for that. At night, it’s what you ask when you are screaming at the sky,” he said. 

    Jay Adams, an HIV care coordinator at the federal Ryan White HIV/AIDS program, said that the outbreak would have been significantly worse in any other county. 

    “I don’t think this would have been contained with any degree of success in any other county in the state,” he said. 

    High-Risk Counties

    A 2016 report from the Centers for Disease Control and Prevention (CDC) identified counties that were at high risk for new HIV infections because of the prevalence of intravenous drug use. Half of West Virginia’s counties—including Cabell—were on the list.

    Other areas of the country, including Indiana and Massachusetts have seen spikes in HIV infections related to the opioid epidemic. 

    John Wiesman, Washington state health secretary and co-chair the Presidential Advisory Council on HIV/AIDS, said that officials are realizing how much the opioid epidemic is impacting HIV transmission. The Trump administration has aimed to stop new HIV transmissions by 2030, but that is a lofty goal, said Wiesman. 

    “We’re recognizing every day just how big a challenge this is,” he said. “There are a lot of things making this a really difficult task, and one of those is the opioid epidemic. We’ve got all of these overlapping issues coming together, a lot of which are social factors, which is why it is so important to have both a medical approach and a larger health and human services approach to this epidemic.”

    View the original article at thefix.com

  • HIV Outbreak In Massachusetts Linked To Injection Drug Use

    HIV Outbreak In Massachusetts Linked To Injection Drug Use

    Between 2015 and 2018 there were 129 new HIV cases linked to drug use in two Massachusetts cities.

    Fentanyl use in two Massachusetts cities is driving an HIV outbreak that officials say could be forecasting a national public health crisis.

    Lawrence and Lowell Massachusetts, two cities along the New Hampshire border, have seen such a sharp spike in new HIV cases that the Centers for Disease Control and Prevention has become involved, according to The Huffington Post.

    Between 2015 and 2018 there were 129 new HIV cases linked to drug use diagnosed in the cities. In the four years prior to that there were only 41 new cases of HIV related to injecting drugs diagnosed annually in the entire state.

    “This tells us we cannot rest on our laurels,” said Thomas Stopka, an infectious disease epidemiologist and assistant professor at Tufts University School of Medicine. “There are potentially other communities that are at great risk as well. HIV can and is raising its head again in places where risks align.”

    In 2015, opioid injecting was linked to an HIV outbreak in rural Indiana. The risk factors in the Massachusetts outbreak are similar, but in an urban setting. One risk is pervasive fentanyl use. Because the synthetic opioid has a shorter half life than heroin, users inject more often. This means they have more opportunity to be exposed to dirty needles.

    In addition, neither city had a needle exchange program before the outbreak, although both have since established exchanges. Finally, high rates of homelessness compound health risks, as does the fact that doctors don’t routinely screen for HIV, even among intravenous drug users.

    “This may be forecasting what could conceivably happen around the country,” said Amy Nunn, executive director of the Rhode Island Public Health Institute.

    This spring, epidemiologists from the CDC spent time in Lawrence and Lowell to try to establish why the outbreak was occurring. They presented their findings in a meeting on July 24.

    “The most striking finding was the sheer number of cases,” said Stopka “[It] was substantially higher than what was seen in years prior.”

    The number of new drug-related HIV cases “definitely caught a lot of folks’ attention and really spoke to the great need in terms of a response,” he said.

    Most of the new cases were among white men ages 20-39, men like Mark, a 29-year-old who injected drugs before finding out that he was HIV positive.

    “We all use,” Mark said. “We all know the other one has it. We don’t tell each other. People will lie right to your face about having it. It’s spreading around like wildfire.”

    Stigma around HIV — even among drug users — keeps them from disclosing their status even if they know if. In addition, the draw of a high can cause people to put their health on the back burner, Mark said.

    “People just don’t care,” he said. “When it comes down to it, if you’ve got a bag in your hand and somebody next to you’s got a dirty needle, you’re not going to run and find a clean one.”

    View the original article at thefix.com