HIV, opioid epidemics linked; health officials identify virus cluster in Cabell

MORGANTOWN — Intravenous drug use, tied closely with the opioid epidemic, is the main source fueling an active HIV cluster in Cabell County.
“In the last five years, their average was eight cases per year,” said Dr. Lee B. Smith, Monongalia County Heath Department executive director and county health officer. “And in 2018, they saw 18. Since then, they’ve been looking harder.”
During a conference call last week, Smith said officials reported there are now 46 confirmed cases of the virus in the county, of which Huntington is the county seat.
“Th are homeless or have unstable housing.”
He added that the age range for individuals diagnosed is 20-54, with the mean being a 34-year-old.
This uptick in cases coincides with findings by infectious diseases expert Sally Hodder, director of the West Virginia Clinical and Translational Science Institute and associate vice president for clinical and translational science at West Virginia University. Hodder was part of a national team that published “AIDS in America — Back in the Headlines at Long Last,” which provides detailed information about the ongoing HIV epidemic.
Hodder said estimates have 1.1 million Americans living with HIV, and more than 15,800 people who were diagnosed with the virus died in 2017, according to a release.
She goes on to say that the epidemic is tied with the opioid crisis. West Virginia has the highest opioid death rate in the nation, according to a 2018 report by the National Center for Health Statistics.
The HIV cluster in Cabell County is the first in the state where intravenous drug use is the primary risk factor. Smith said there are roughly 1,800 active IV drug users there and that in order to combat the issue, Cabell Huntington Hospital has a robust harm reduction clinic that, in the last four years, has seen about 400 patients annually. A harm reduction clinic uses various methods, often including a syringe access program, with the aim to reduce negative consequences from drug use.
“Some people don’t want to come in because of the stigma,” Smith said. “Or they can function at their job, and may not see the need to come in for testing.”
But for those who do arrive at the clinic, or any STD clinic the county offers, Smith said workers are using advances in surveillance techniques to get a better handle on the number of HIV cases.
“In the past, we would just focus on your complaint,” he said. “Now that we know that some people present an increased risk because of their type of behavior, we encourage them to have additional testing.”
According to Smith, the West Virginia Bureau for Public Health and the CDC are looking closely at areas in the state where HIV may spread.
“At this time, they are not seeing the cluster spread further than Cabell County.”
In the past year, the Monongalia County Health Department has worked with Harrison and Marion counties to host several STD clinics. In that time, Smith said, of the 2,000 people who have been tested, only one tested positive for HIV.
However, he warned, as the weather warms and people are more likely to move around, it is also more likely that the virus will spread.
In order to combat the rising number of HIV cases here and across the nation, the perspective that Hodder contributed to, published in the New England Journal of Medicine, states a number of social, economic and cultural barriers must be addressed.
While Smith first cites education as a tool to stem the tide, he said, “it’s also compassion and extending services.”
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