How a West Virginia county stemmed an HIV outbreak

From 2018 to 2019, West Virginia had an HIV outbreak among people who injected drugs, but was able to curb it using the four pillars of a federal initiative to end the HIV epidemic by 2030, according to MedPage Today.

Robert McClung, MD, of the CDC, detailed the efforts taken in Cabell County, W.Va., a county of about 350,000 residents, which saw a sharp increase in HIV infections. An average of two diagnosed HIV cases a year among injection drug users in the county ballooned to 82 total cases diagnosed from January 2018 to October 2019. Nearly all HIV cases diagnosed in that span were among injection drug users.

Dr. McClung said that the outbreak had an infection rate that was 18 times the estimated national rate, MedPage Today reports.

Public health officials responded quickly, one pillar of the federal initiative. First, they developed a definition for HIV cases diagnosed after January 2018 among injection drug users in Cabell County.

The next pillar is moving to diagnose people. The CDC sent disease intervention specialists to help state health officials quickly diagnose people and identify HIV cases.

The third pillar is treating people with sustained viral suppression as a goal, which means reducing the levels of a virus in an organism. West Virginia officials worked to improve access to care and reduce barriers to retaining care, including linking those with opioid use disorders to medication-assisted treatment.

The fourth pillar is preventing new transmission, and West Virginia officials did this by increased access to a pill that prevents HIV. They worked with hospitals in the area "to train over 100 providers to assist with PrEP implementation," said Dr. Dr. McClung, MedPage Today reports.

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