This session is directed to clinicians and scientists interested in the evolving epidemiology of HIV infection among persons who inject drugs. It is assumed participants are familiar with the principles of HIV transmission, its control, and the epidemiology of HIV infection in the United States. At completion of the session, participants will understand how to prevent potential outbreaks of HIV infection among new populations of persons who inject drugs, and to recognize and respond to an outbreak should one occur.
HIV infections attributable to injection drug use in the U.S. have declined steadily since the early 1990s and have accounted for less than 8% of all diagnosed infections since 2010. In early 2015, public health workers serving a small rural Indiana community (adult population approximately 3,100) detected an outbreak of HIV infections within a network of persons who injected drugs. The ensuing investigation identified over 180 new HIV infections that had mostly occurred since mid-2014. Controlling the outbreak demanded a large and coordinated response by county, state and federal partners working closely with the community and other stakeholders. Fueled by the growing national epidemic of opioid drug abuse, injection drug use – heralded by viral hepatitis C infections – is spreading among populations not previously considered to be at high risk of HIV infection. Clinicians and public health authorities will need to work together with policy makers and at-risk communities to prevent similar future HIV outbreaks as the context of injection drug use in the U.S. evolves.