<i>Notes from the Field:</i> HIV Outbreak During the COVID-19 Pandemic Among Persons Who Inject Drugs — Kanawha County, West Virginia, 2019–2021
Rebecca B. Hershow, Suzanne M. Wilson, Robert A. Bonacci, Molly Deutsch-Feldman, Olivia Ollinger Russell, S. Young, Shannon McBee, Erica D. Thomasson, Shawn Balleydier, Miracle Boltz, Vicki Hogan, Amy Atkins, Nancy Worthington, Robert McDonald, Monica Adams, Anne C. Moorman, Danae Bixler, Stephen Kowalewski, Melinda Salmon, R. Paul McClung, Alexandra M. Oster, Kathryn Curran
Abstract
During October 2019, the West Virginia Bureau for Public Health (WVBPH) noted that an increasing number of persons who inject drugs (PWID) in Kanawha County received a diagnosis of HIV. The number of HIV diagnoses among PWID increased from less than five annually during 2016-2018 to 11 during January-October 2019 (Figure). Kanawha County (with an approximate population of 180,000*) has high rates of opioid use disorder and overdose deaths, which have been increasing since 2016, and the county is located near Cabell County, which experienced an HIV outbreak among PWID during 2018-2019 (1,2). In response to the increase in HIV diagnoses among PWID in 2019, WVBPH released a Health Advisory ; and WVBPH and Kanawha-Charleston Health Department (KCHD) convened an HIV task force, conducted care coordination meetings, received CDC remote assistance to support response activities, and expanded HIV testing and outreach. After suspension of the KCHD syringe services program (SSP) in March 2018 and a community-based SSP in April 2021 (because of concerns about program administration), a state law and a Charleston City Council ordinance** enacted stricter SSP requirements. No new SSPs have opened in Kanawha County since the legislation passed. During 2020-2021, the COVID-19 pandemic affected HIV response activities and in-person services for PWID (e.g., curtailment of partner services, limitation in outreach testing, and closure * https://www.census.gov/quickfacts/kanawhacountywestvirginia (