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. 2019 Jun:34:12-17.
doi: 10.1016/j.annepidem.2019.02.012. Epub 2019 Mar 6.

Increased HIV diagnoses in West Virginia counties highly vulnerable to rapid HIV dissemination through injection drug use: a cautionary tale

Heather Bradley  1 , Vicki Hogan  2 , Christine Agnew-Brune  1 , John Armstrong  2 , Dawn Broussard  3 , Kate Buchacz  1 , Kenya Burton  2 , Scott Cope  1 , Erica Dawson  1 , Gloria De La Garza  3 , Anthony Gerard  3 , Michael Granado  3 , Rahul Gupta  2 , Loretta Haddy  2 , William Hoffman  2 , Shacara D Johnson  3 , Nathan Kirk  2 , Chang Lee  3 , Sheryl Lyss  1 , Miguella Mark-Carew  2 , Laura Quilter  3 , Pamela Reynolds  2 , Bridget Rose  2 , Antoine Thompson  3 , Lisa Varella  3 , Paul Weidle  1 , Brunilis White  3 , David Wills  2 , Sherri A Young  2 , Brooke E Hoots  4
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Increased HIV diagnoses in West Virginia counties highly vulnerable to rapid HIV dissemination through injection drug use: a cautionary tale

Heather Bradley et al. Ann Epidemiol. 2019 Jun.

Abstract

Purpose: To investigate HIV transmission potential from a cluster of HIV infections among men who have sex with men to persons who inject drugs in 15 West Virginia counties. These counties were previously identified as highly vulnerable to rapid HIV dissemination through injection drug use (IDU) associated with high levels of opioid misuse.

Methods: We interviewed persons with 2017 HIV diagnoses about past-year risk behaviors and elicited sexual, IDU, and social contacts. We tested contacts for HIV and assessed risk behaviors. To determine HIV transmission potential from persons with 2017 diagnoses to persons who inject drugs, we assessed viral suppression status, HIV status of contacts, and IDU risk behaviors of persons living with HIV and contacts.

Results: We interviewed 78 persons: 39 with 2017 diagnoses and 39 contacts. Overall, 13/78 (17%) injected drugs in the past year. Of 19 persons with 2017 diagnoses and detectable virus, 9 (47%) had more than or equal to 1 sexual or IDU contacts of negative or unknown HIV status. During the past year, 2/9 had injected drugs and shared equipment, and 1/9 had more than or equal to 1 partner who did so.

Conclusions: We identified IDU risk behavior among persons with 2017 diagnoses and their contacts. West Virginia HIV prevention programs should continue to give high priority to IDU harm reduction.

Keywords: Epidemiology; HIV prevention; Injection drug use; Investigation; Sexual network.

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Conflict of interest statement

Conflicts of interest: No conflicts of interest have been declared for any author on this article.

Figures

Fig. 1.
Fig. 1.
Fifteen counties of intensified HIV contact tracing efforts from October 16 to November 9, 2017–West Virginia.
Fig. 2.
Fig. 2.
Network of 2017 HIV diagnoses and contacts by HIV status and IDU in the past 12 months – West Virginia, 15 counties.
Fig. 3.
Fig. 3.
Risk behaviors that could result in bridging of HIV to the population of persons who inject drugs.
See this image and copyright information in PMC

Comment in

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