Response to a Large HIV Outbreak, Cabell County, West Virginia, 2018-2019.

Autor: McClung RP; Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia; U.S. Public Health Service Commissioned Corps, Atlanta, Georgia. Electronic address: rmcclung@cdc.gov., Atkins AD; West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia., Kilkenny M; Cabell-Huntington Health Department, Huntington, West Virginia., Bernstein KT; Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia., Willenburg KS; Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia., Weimer M; Valley Health System, Huntington, West Virginia., Robilotto S; HIV/AIDS Bureau, Health Resources & Services Administration, Rockville, Maryland., Panneer N; Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia., Thomasson E; West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia; Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia., Adkins E; Cabell-Huntington Health Department, Huntington, West Virginia., Lyss SB; Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia; U.S. Public Health Service Commissioned Corps, Atlanta, Georgia., Balleydier S; West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia., Edwards A; U.S. Public Health Service Commissioned Corps, Atlanta, Georgia; HIV/AIDS Bureau, Health Resources & Services Administration, Rockville, Maryland., Chen M; Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia., Wilson S; West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia., Handanagic S; Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia., Hogan V; West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia., Watson M; Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia., Eubank S; West Virginia Department of Health & Human Resources, West Virginia Bureau for Public Health, Charleston, West Virginia., Wright C; Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia., Thompson A; Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia., DiNenno E; Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia., Fanfair RN; Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia; U.S. Public Health Service Commissioned Corps, Atlanta, Georgia., Ridpath A; Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia., Oster AM; Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia; U.S. Public Health Service Commissioned Corps, Atlanta, Georgia.
Jazyk: angličtina
Zdroj: American journal of preventive medicine [Am J Prev Med] 2021 Nov; Vol. 61 (5 Suppl 1), pp. S143-S150.
DOI: 10.1016/j.amepre.2021.05.039
Abstrakt: Introduction: In January 2019, the West Virginia Bureau for Public Health detected increased HIV diagnoses among people who inject drugs in Cabell County. Responding to HIV clusters and outbreaks is 1 of the 4 pillars of the Ending the HIV Epidemic in the U.S. initiative and requires activities from the Diagnose, Treat, and Prevent pillars. This article describes the design and implementation of a comprehensive response, featuring interventions from all pillars.
Methods: This study used West Virginia Bureau for Public Health data to identify HIV diagnoses during January 1, 2018-October 9, 2019 among (1) people who inject drugs linked to Cabell County, (2) their sex or injecting partners, or (3) others with an HIV sequence linked to Cabell County people who inject drugs. Surveillance data, including HIV-1 polymerase sequences, were analyzed to estimate the transmission rate and timing of infections using molecular clock phylogenetic analysis. Federal, state, and local partners designed and implemented a comprehensive response during January 2019-October 2019.
Results: Of 82 people identified in the outbreak, most were male (60%), were White (91%), and reported unstable housing (80%). In a large molecular cluster containing 56 of 60 (93%) available sequences, 93% of inferred transmissions occurred after January 1, 2018. HIV testing, HIV pre-exposure prophylaxis, and syringe services were rapidly expanded, leading to improved linkage to HIV care and viral suppression.
Conclusions: Evidence of rapid transmission in this outbreak galvanized robust collaboration among federal, state, and local partners, leading to critical improvements in HIV prevention and care services. HIV outbreak response requires increased coordination and creativity to improve service delivery to people affected by rapid HIV transmission.
(Published by Elsevier Inc.)
Databáze: MEDLINE
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