HIV spike among drug users worries health officials
- By Christian M. Wade Statehouse Reporter
From Jan. 1 to Nov. 21, there were 64 new cases of the human immunodeficiency virus among individuals who inject drugs, representing 14 percent of all HIV cases reported this year, according to the state Department of Public Health.
"It's very worrisome, and we're trying to get the word out," said Dr. Alfred DeMaria, medical director for the department’s Bureau of Infectious Disease Prevention. "Basically all the other risk categories for HIV infections have been on a downward trend, while this category is going up."
DeMaria said state officials are investigating the uptick and have issued a rare clinical advisory to health care providers and local boards of health.
The increase comes after years of overall declining HIV infections, largely attributed to the success of public health campaigns and needle exchange programs.
From 2000 to 2015, the number of new HIV diagnoses declined 47 percent, from 1,191 to 629, according to the latest data from the Executive Office of Health and Human Services.
As of Dec. 2015, there were an estimated 21,000 people in the state with HIV, according to the agency.
'Not surprising'
Carl Sciortino, executive director of the AIDS Action Committee of Massachusetts, said the uptick in HIV infections among drug users is "alarming but frankly not surprising, given what is happening with the opioid crisis."
"We've had a perfect storm of elements in place for an HIV outbreak in this population, and this is the first indication that we may be losing ground when it comes to preventing the spread of HIV among people who inject drugs," he said.
Sciortino said in recent years the number of needle exchange programs have increased to more than 20, including two run by AIDS Action. But, he added, there aren't enough to reach everyone.
"We know the opioid crisis is happening everywhere and people who are active injectors aren't likely to travel far," he said. "They're one of the state's most geographically isolated populations."
He also said the Baker administration has cut funding for HIV prevention by $4.8 million in the current budget.
"Unfortunately, right now there isn't a lot of money to work with to expand those programs," he said.
In 2006, the state passed a law allowing pharmacies to sell syringes over the counter to anyone 18 years or older, and decriminalizing the possession of needles. The state also allows local boards of health to authorize needle exchanges to distribute unused syringes.
"Needle exchanges are a well-documented approach to reducing the risk of infection for people who inject drugs," DiMaria said.
But the federal Centers for Disease Control and Prevention issued a public health advisory to Massachusetts and other states two years ago following a major outbreak of HIV and hepatitis C in a rural county in southern Indiana that was linked to needle sharing. In that outbreak, one HIV-infected individual was believed to have sparked a wave of more than 180 new infections within a four-month period.
Finding needle sharers
DeMaria said DPH is trying to determine if new HIV cases among drug users in Massachusetts involve needle sharing, but he noted the challenges of finding the infected individuals.
"They're often very mobile, which makes it hard to track them down," he said. "They're living on the street, on someone's couch or in a shelter and can't be reached."
He said the introduction of fentanyl means intravenous users are injecting smaller doses of drugs more frequently, increasing the risk.
"HIV outbreaks can happen at anytime in a needle-sharing network," he said. "And once it starts spreading, it can spread very quickly."
Christian M. Wade covers the Massachusetts Statehouse for The Salem News and its sister newspapers and websites. Email him at cwade@cnhi.com.
No comments:
Post a Comment