Increased HIV diagnoses in West Virginia counties highly vulnerable to rapid HIV dissemination through injection drug use: a cautionary tale

Bradley, Heather; Hogan, Vicki; Agnew-Brune, Christine; Armstrong, J. Scott; Broussard, Dawn; Buchacz, Kate; Burton, Kenya; Cope, Scott; Dawson, Erica L.; Garza, Gloria De La; Gerard, Anthony; Granado, Michael; Gupta, Rahul; Haddy, Loretta; Hoffman, William A.; Johnson, Steven; Kirk, Nathan; Brasier, Allan R.; Lyss, Sheryl; Mark-Carew, Miguella; Quilter, Laura; Reynolds, Pamela; Rose, Bridget; Thompson, Antoine; Varella, Lisa; Weidle, Paul J.; White, Brunilís B.; Wills, David; Young, S.; Hoots, Brooke

doi:10.1016/j.annepidem.2019.02.012

Cited by 32 publications

(24 citation statements)

References 11 publications

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“…At-home HIV testing presents an innovative opportunity to increase access to and frequency of HIV testing among at-risk populations such as rural PWUD. With increasing IDU in rural areas and emerging HIV cases [6][7][8][9][12][13][14][15], approaches to better reach the needs of this population are warranted. This study revealed that a majority of rural PWUD may be willing to complete an at-home blood-spot HIV test, but unknown barriers may inhibit completion of tests or retrieval of results.…”

Section: Resultsmentioning

confidence: 99%

“…With the growing rate of injection drug use (IDU) and the emerging hepatitis C (HCV) epidemic in the United States (US) [ 6 – 11 ], new HIV infections in these communities are of major concern. While Scott County, Indiana’s HIV outbreak in 2014–2015 [ 11 , 12 ] is most notable, clusters of new HIV infections associated with IDU continue to emerge in various states across the US including West Virginia [ 9 , 13 , 14 ] and Massachusetts [ 15 ]. Central to prevention efforts to mitigate the growing incidence of HIV transmission among people who inject drugs (PWID) are services that can provide testing and linkage to care.…”

Section: Introductionmentioning

confidence: 99%

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Willingness to Participate in At-Home HIV Testing Among Young Adults Who Use Opioids in Rural Appalachia

et al. 2020

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New HIV infections associated with injection drug use are of major concern in rural US communities. This study explores acceptability of, consent for, and uptake of free at-home HIV testing among people who use drugs (PWUD) in one of the nation's epicenters for drug-related harms and HIV vulnerability: Rural Central Appalachia. Eligible participants were 18-35 years old, lived in Appalachian Kentucky, and reported using opioids to get high in the previous 30 days. A majority reported being likely (63.6%, 96/151) to take a free at-home HIV tests and 66.9% (101/151) consented to receive one. Among those who were randomly selected to receive a Home Access HIV-1 test kit (n = 37), 37.8% mailed in blood spots and 21.6% called to receive results. This study provides evidence that PWUD may be willing to take an at-home test, but other barriers may inhibit actual completion.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Willingness to Participate in At-Home HIV Testing Among Young Adults Who Use Opioids in Rural Appalachia

et al. 2020

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“…Genetic clustering is increasingly used to assess HIV outbreaks, particularly among people who inject drugs [15] , [16] , [17] and other vulnerable groups. One of the 4 pillars of the strategic initiative to Ending the HIV Epidemic in the United States is to rapidly detect and respond to emerging clusters of HIV infection to reduce new transmissions [7] .…”

Section: Discussionmentioning

confidence: 99%

HIV-1 Transmission linkages among persons with incident infection to inform public health surveillance

et al. 2021

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Background We evaluated features of HIV transmission networks involving persons diagnosed during incident HIV infection (IHI) to assess network-based opportunities to curtail onward transmission. Methods Transmission networks were constructed using partial pol sequences reported to North Carolina surveillance among persons with recent (2014–2018) and past (<2014) HIV diagnoses. IHI were defined as documented acute infections or seroconversion. Demographic and virologic features of HIV genetic clusters (<1.5% pairwise genetic distance) involving ≥ 1 IHI were assessed. Persons with viral genetic links and who had diagnoses >90 days prior to an IHI were further characterized. We assessed named partner outcomes among IHI index persons using contact tracing data. Findings Of 4,405 HIV diagnoses 2014–2018 with sequences, there were 323 (7%) IHI index persons; most were male (88%), Black (65%), young (68% <30 years), and reported sex with men (MSM) risk (79%). Index persons were more likely to be cluster members compared to non-index persons diagnosed during the same period (72% vs. 49%) . In total, 162 clusters were identified involving 233 IHI, 577 recent diagnoses, and 163 past diagnoses. Most IHI cases (53%) had viral linkages to ≥1 previously diagnosed person without evidence of HIV viral suppression in the year prior to the diagnosis of the IHI index. In contact tracing, only 53% IHI cases named an HIV-positive contact, resulting in 0.5 previously diagnosed persons detected per IHI investigated. When combined with viral analyses, the detection rate of viremic previously diagnosed persons increased to 1.3. Interpretation Integrating public health with molecular epidemiology, revealed that more than half of IHI have viral links to persons with previously diagnosed unsuppressed HIV infection which was largely unrecognized by traditional contact tracing. Enhanced partner services to support engagement and retention in HIV care and improved case finding supported by rapid phylogenetic analysis are tools to substantially reduce onward HIV transmission.

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“…HIV-1 infection is a major cause of morbidity and mortality in the world and affects a portion of the adult population at the peak of their professional life, causing a great economic impact in many countries [ 15 , 16 ]. The prevalence of HIV-1 infection is higher in population groups that share common risk factors, including men who have sex with men, intravenous drug users, people in prisons and other closed environments, sex workers and trans people [ 17 , 18 , 19 ]. Transmission through sexual intercourse remains the most common, although there are several forms of prevention, including the use of condoms and prophylactic pre-exposure schemes (PrEP) [ 20 ].…”

Section: The Impact Of Hiv-1 In the Brazilian Amazon: From Description To Current Timesmentioning

confidence: 99%

The Epidemiological Impact of STIs among General and Vulnerable Populations of the Amazon Region of Brazil: 30 years of Surveillance

Machado

Fonseca

Queiroz

et al. 2021

Viruses

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Sexually transmitted infections (STIs) represent a worldwide public health problem and, although many of them are curable, they continue to be neglected, especially in areas with a low human development index, such as in the northern region of Brazil. This review describes the results of 30 years of studies at the Virus Laboratory at the Federal University of Pará, including the prevalence and molecular epidemiology of HIV-1, HTLV-1/2, HPV, HBV, Treponema pallidum and Chlamydia trachomatis among urban and non-urban populations, and also in vulnerable groups in the Brazilian Amazon. Control strategies and challenges in preventing STIs are discussed considering this immense geographic region, where essential health services are unable to reach the entire population, especially the most vulnerable, such as female sex workers, people who use illicit drugs, remnants of quilombolos and indigenous communities.

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Increased HIV diagnoses in West Virginia counties highly vulnerable to rapid HIV dissemination through injection drug use: a cautionary tale

Cited by 32 publications

References 11 publications

Willingness to Participate in At-Home HIV Testing Among Young Adults Who Use Opioids in Rural Appalachia

Willingness to Participate in At-Home HIV Testing Among Young Adults Who Use Opioids in Rural Appalachia

HIV-1 Transmission linkages among persons with incident infection to inform public health surveillance

The Epidemiological Impact of STIs among General and Vulnerable Populations of the Amazon Region of Brazil: 30 years of Surveillance

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