On March 22, 2019, the West Virginia Bureau for Public Health sent Health Advisory #155 to health care providers, hospitals and other health care facilities. It reported an increase in new HIV diagnoses among people who inject drugs.
In the past, male-to-male sexual contact was the most common reported risk factor for HIV in the state. Since 2018, more new HIV cases had listed injection drug use as a risk factor.
The state had been looking into a rise in Cabell County since January 2019. Based on 2013 to 2017, Cabell County expected about eight new HIV diagnoses a year from all risk factors. In 2018, 17 people who inject drugs were diagnosed there, seven of them in the last three months of the year. Another 13 were diagnosed from January 1, 2019, to the date of the advisory, for a total of 30 since January 1, 2018.
What providers were asked to do
The advisory asked providers to screen all patients for a history of injection drug use. People who inject drugs were to be:
- Tested at least once a year for HIV, hepatitis C, hepatitis B, syphilis, gonorrhea and chlamydia
- Asked to refer sex or needle-sharing partners for testing
- Referred to harm reduction programs where available, and taught safe injection practices
- Offered or referred to substance use disorder treatment, including medication-assisted treatment
- Referred for pre-exposure prophylaxis (PrEP) if at high risk of sexual spread of HIV
For all patients, the advisory repeated that people age 15 through 65 should get an HIV test at least once, and people at high risk at least once a year. When a patient tested positive, providers were to link the patient to HIV care right away, contact the state’s disease intervention staff through the West Virginia STD/HIV Hotline at 1-800-642-8244, and report the case within one week.
Later in 2019, the state reported a second increase among people who inject drugs, this time in Kanawha County. See Health Advisory #162, Health Advisory #158 on routine HIV testing and the HIV task force.
This guidance is from March 2019. It is kept here as a record and is not current advice. Check current guidance from the CDC or your doctor.