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Rural Areas of the United States Continue to Grapple with Outbreaks of HIV

In a story that could be straight out of the 1980s, health officials in the state of West Virginia have stated they are dealing with a major outbreak of HIV infections in the southern part of the state.

According to a report from the local newspaper, the Charleston Gazette-Mail, Rahul Gupta, MD, state health officer and commissioner for West Virginia’s Department of Health and Human Resources (DHHR) Bureau for Public Health stated that the outbreak comprises individuals from 15 counties. “The number of cases qualified as an outbreak because more cases than expected occurred in a window of time,” said Dr. Gupta. “The DHHR found linkages, meaning common sexual partners.” Officials purport that the virus spread through male–male sexual contact, with only some of the individuals becoming infected through intravenous drug use.

State officials first noticed an increase in HIV infections in the southern portion of the state in 2015, when 68 cases were reported. Another increase was observed in August 2017. This spurred officials to step up surveillance and identify who was infected, according to the reports. After identification, officials focused on linking those infected with care.

According to the Centers for Disease Control and Prevention (CDC), 1 in 302 West Virginians will be diagnosed with HIV in their lifetime. And, while the state is known to have the highest incidence of acute hepatitis B and C, a total of 28 counties have also been identified as high-risk for HIV.

As of the week of November 6, 2017, a total of 60 new cases were reported across the state. The latest reports have indicated that the outbreak has since been contained as many of those who were infected were identified and connected with treatment.

This is not the first time in recent years that a rural area of a US state has seen an outbreak of HIV. In 2016, Contagion® covered a report on 220 counties in the United States that were identified as being potentially vulnerable to HIV (and hepatitis C virus) infections “among people who inject drugs within the context of the national opioid epidemic.” These counties were identified after a cluster of 194 HIV cases were reported in the rural community of Austin, Indiana, in 2015. That outbreak was directly linked with the sharing of needles.

To stop more outbreaks from happening because of needle-sharing, many states have set up what have been called “harm-reduction programs,” which include needle-exchange services.

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