In Massachusetts, a Troubling Cluster of New HIV Infections Among Injection Drug Users

This month, a team of Centers for Disease Control and Prevention (CDC) investigators is heading to northeast Massachusetts to assist the state's department of public health (DPH) address a cluster of new HIV infections among people who inject drugs and/or experience homelessness. Preliminary data from the Lowell and Lawrence region shows 52 new HIV cases in 2017 among injection drug users, compared to 23 in 2016.

The 2015 HIV outbreak in Scott County, Indiana served as a warning to Massachusetts communities about the infectious disease consequences of the opioid crisis. The impact of fentanyl on the region's drug supply is similar to the impact of OPANA® ER-use found in the Scott County outbreak. The short duration of action by these opioids increased the need to inject frequently, as compared to heroin. More injections mean greater risk for blood-borne pathogen transmission.

Since 2016 the Massachusetts DPH responded by mobilizing HIV and hepatitis C screening among people who use drugs and sending out mobile outreach units to programs serving people at-risk. DPH increased the number of needle exchange programs across the state four-fold. In June of 2017, the state's Supreme Judicial Court ruled in favor of pubic health policy, deciding that local jurisdictions cannot ban private organizations from operating syringe access programs.

Related: HIV Among People Who Inject Drugs

The local response already underway: Peer Education and Risk Reduction Services, a coalition in Lowell, recently added a fixed-site to its existing mobile syringe access program and will also emphasize meaningful participant involvement. A grant to establish a peer education program was recently awarded to them by the University of Baltimore. By engaging people who have lived with substance use disorder, HIV, or homelessness experience to become peer educators, they're hoping to have a more significant impact on Lowell's opioid crisis.

With overdose and HIV and viral hepatitis infection rates rising in Lowell and Lawrence, despite the accomplishments of the State of Massachusetts in bulking up its public health and health care infrastructure, DPH has formally asked the CDC for support in their investigation. The CDC team arrives this month and will spend three weeks sequencing the genomes of viral samples and interviewing people impacted by HIV.

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[Note from TheBody: This article was originally published by AIDS United on Apr. 20, 2018. We have cross-posted it with their permission.]