Opioid Use Fueling HIV Transmission in an Urban Setting: An Outbreak of HIV Infection Among People Who Inject Drugs-Massachusetts, 2015-2018.

Publisher: American Public Health Association Country of Publication: United States NLM ID: 1254074 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1541-0048 (Electronic) Linking ISSN: 00900036 NLM ISO Abbreviation: Am J Public Health Subsets: MEDLINE

Publication: Washington, DC : American Public Health Association
Original Publication: New York [etc.]

Public Health Practice*; HIV Infections/*epidemiology ; HIV Infections/*prevention & control ; Opioid-Related Disorders/*epidemiology ; Substance Abuse, Intravenous/*epidemiology; Adolescent ; Adult ; Community Participation ; Female ; Genotype ; HIV Infections/diagnosis ; HIV Infections/etiology ; Health Services Accessibility ; Ill-Housed Persons/statistics & numerical data ; Humans ; Male ; Massachusetts/epidemiology ; Middle Aged ; Needle-Exchange Programs/organization & administration ; Polymerase Chain Reaction ; Racial Groups ; Urban Population/statistics & numerical data ; Young Adult ; pol Gene Products, Human Immunodeficiency Virus/genetics

Objectives. To describe and control an outbreak of HIV infection among people who inject drugs (PWID). Methods. The investigation included people diagnosed with HIV infection during 2015 to 2018 linked to 2 cities in northeastern Massachusetts epidemiologically or through molecular analysis. Field activities included qualitative interviews regarding service availability and HIV risk behaviors. Results. We identified 129 people meeting the case definition; 116 (90%) reported injection drug use. Molecular surveillance added 36 cases to the outbreak not otherwise linked. The 2 largest molecular groups contained 56 and 23 cases. Most interviewed PWID were homeless. Control measures, including enhanced field epidemiology, syringe services programming, and community outreach, resulted in a significant decline in new HIV diagnoses. Conclusions. We illustrate difficulties with identification and characterization of an outbreak of HIV infection among a population of PWID and the value of an intensive response. Public Health Implications. Responding to and preventing outbreaks requires ongoing surveillance, with timely detection of increases in HIV diagnoses, community partnerships, and coordinated services, all critical to achieving the goal of the national Ending the HIV Epidemic initiative.

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0 (pol Gene Products, Human Immunodeficiency Virus)

Date Created: 20191115 Date Completed: 20200427 Latest Revision: 20221207

20240105

PMC6893347

10.2105/AJPH.2019.305366

31725317