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Kanawha HIV Task Force hears from national, state health leaders on ‘concerning’ trends

CHARLESTON, W.Va. — Kanawha County’s HIV Task Force met for the first time in months Thursday and heard presentations from both the U.S. Centers for Disease Control and the West Virginia Department of Health and Human Resources on the growing trends in the county.

Dr. Demetre Daskalakis, the head of HIV prevention for the U.S. Centers for Disease Control, spoke during the meeting and called the county’s HIV outbreak one of the most concerning in the United States. He said it could take ā€œmultiple years” to address it.

Demetre Daskalakis

Shannon McBee, MPH, CHES, State Epidemiologist conducted the presentation titled, ‘HIV Outbreak in Kanawha County Associated with Injection Drug Use.’ According to the DHHR, there were 42 HIV cases recorded in 2020 in Kanawha County and one so far in 2021.

In her presentation, McBee said West Virginia saw the emergence of HIV among persons who inject drugs (PWID) beginning in 2017 with a Kanawha County cluster forming between 2018 and 2019.

She broke down PWID and how they are stigmatized, recurring, and have high rates of co-morbidities. She said West Virginia has been increasingly vulnerable to HIV outbreaks among persons who inject drugs.

“Sharing the injection drug equipment as well as high-risk sexual practices associated with substance use generates this vulnerability,” McBee said.

VIEW: McBee’s entire presentationĀ 

She then broke down the epidemiology of HIV in Kanawha County and noted based on a five-year average (2013-2017), the expected number of cases in Kanawha County per year is 14 with fewer than five cases associated with injection drug use.

Shannon McBee

The significant increase in new HIV diagnosis began in 2019 driven by cases associated with injection drug use (IDU), according to her data. The number of new HIV associated self-identified injection drug use increased from 15 cases in 2019 to 35 cases in 2020. They were less than five in 2018.

Since the beginning of 2019, 51 newly diagnosed cases of HIV associated with injection drug use have been reported in Kanawha County, the data showed. Around 53% were male and 83% of cases are between 20 and 40 years of age. Broken down even further, 59% 30-39 years old and 24% 20-29 years old.

Other breakdowns of those 51 cases include 53% of cases were diagnosed in a hospital setting, 83% received care after HIV diagnosis (71% within 30 days of diagnosis), 16% received care within the last 90 days, 18% have no evidence of care, and 31% have ever been virally suppressed.

McBee spoke on the challenges with HIV cases in Kanawha County that include individuals being difficult to locate for case investigation, care and support services. She said this has only gotten tougher because of the COVID-19 pandemic.

“The COVID-19 pandemic has significantly impacted this population’s ability to access services for shelter, food and other needs. Due to COVID restrictions, the very essence of how public health responds has had to adjust,” McBee said.

Other challenges included almost half of the individuals have been diagnosed in a hospital setting because they are in crisis, individuals are not accessing traditional models for healthcare and support services and the deep entrenchment in addiction is a significant barrier to care and support services.

In response to the outbreak, McBee said the state supports harm reduction programs, which has been a hot button issue in the county as of late. Charleston City Council has debated the status of several needle exchange programs in recent meetings.

“We need to implement harm reduction services, making clean needles available and educating people on safe injection practices and conduct referrals for post-exposure prophylaxis,” she said.

She would like to see increased testing efforts in order to detect undiagnosed cases and accessing the population where they seek services through outreach with community organizations.

This was the first scheduled meeting for the group since June 2020, according to the Kanawha Charleston Health Department’s website. Many in the virtual meeting asked to meet monthly.





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