Opioid Use Fueling HIV Transmission in an Urban Setting: An Outbreak of HIV Infection Among People Who Inject Drugs-Massachusetts, 2015-2018
Opioid Use Fueling HIV Transmission in an Urban Setting: An Outbreak of HIV Infection Among People Who Inject Drugs-Massachusetts, 2015-2018
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DOI：
10.2105/ajph.2019.305366
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发表时间：
2020-01-01
影响因子：
12.7
通讯作者：
Buchacz, Kate
中科院分区：
文献类型：
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作者：
Alpren, Charles;Dawson, Erica L.;Buchacz, Kate
目标。目的描述和控制一起注射吸毒者中HIV感染的暴发疫情。这项调查包括2015年至2018年期间被诊断为艾滋病毒感染的人，这些人与马萨诸塞州东北部的两个城市有流行病学联系，或通过分子分析。实地活动包括关于服务可获得性和艾滋病毒风险行为的定性访谈。我们确定了129人符合病例定义；116人(90%)报告使用注射毒品。分子监测增加了36例病例，与疫情没有其他联系。最大的两个分子群分别为56例和23例。大多数受访的PWID是无家可归的。控制措施，包括加强现场流行病学、注射器服务规划和社区推广，导致艾滋病毒新诊率显著下降。我们说明了在PWID人群中识别和描述HIV感染暴发的困难以及密集反应的价值。公共卫生影响。应对和预防疫情需要持续不断的监测，及时发现艾滋病毒诊断的增加、社区伙伴关系和协调服务，所有这些都对实现国家结束艾滋病毒流行倡议的目标至关重要。
Objectives. To describe and control an outbreak of HIV infection among people who inject drugs (PWID).Methods. The investigation included people diagnosed with HIV infection during 2015 to 2018 linked to 2 cities in northeastern Massachusetts epidemiologically or through molecular analysis. Field activities included qualitative interviews regarding service availability and HIV risk behaviors.Results. We identified 129 people meeting the case definition; 116 (90%) reported injection drug use. Molecular surveillance added 36 cases to the outbreak not otherwise linked. The 2 largest molecular groups contained 56 and 23 cases. Most interviewed PWID were homeless. Control measures, including enhanced field epidemiology, syringe services programming, and community outreach, resulted in a significant decline in new HIV diagnoses.Conclusions. We illustrate difficulties with identification and characterization of an outbreak of HIV infection among a population of PWID and the value of an intensive response.Public Health Implications. Responding to and preventing outbreaks requires ongoing surveillance, with timely detection of increases in HIV diagnoses, community partnerships, and coordinated services, all critical to achieving the goal of the national Ending the HIV Epidemic initiative.