The HIV epidemic is in our backyard; here's how we can stop it
June 27 is National HIV Testing Day (NHTD). As a disease that disproportionately affects drug users, gay and bisexual men, African Americans and Latinos, the epidemic has been long stigmatized. Discrimination, fear and judgment have led to widespread misinformation about HIV.
Here are the facts: 1.2 million people in the U.S. are living with HIV, and roughly 13% of them don’t even know it.
HIV stands for human immunodeficiency virus and is spread through sex, unclean needles or can be passed on through birth. AIDS is the most severe form of HIV. Even if you don’t belong to any high-risk groups, HIV is a lot closer to home than you might think.
Charleston, West Virginia has long been a hub for opioid use, namely heroin and fentanyl, which are both injection drugs. Besides overdose deaths, there is another reason why injection drugs are so dangerous. Sharing needles often leads to the spread of viruses like hepatitis B and C and, of course, HIV.
The Centers for Disease Control and Prevention (cdc.gov) has announced that there is an HIV outbreak in Charleston that is the most concerning in the country. Dr. Robin Pollini, associate professor of behavioral medicine and psychiatry and epidemiology at West Virginia University, talked to Here & Now’s Peter O’Dowd about the outbreak in Charleston. Pollini demonstrates just how alarming the scale of the outbreak is when she compares the number of new cases in Charleston to those in New York City last year. The difference? In a city 150 times larger than Charleston, the number of new HIV cases last year was the same in both cities.
This is a stark comparison. While the COVID-19 pandemic was ravaging the country, another epidemic emerged in our state, attacking some of our most vulnerable citizens.
West Virginia’s Syringe Services Programs (SSPs) are a good way for those who inject drugs to receive clean needles in exchange for used ones. Dr. Pollini advocated for the SSPs that exist in Charleston, Huntington and Morgantown.
Milan Puskar Health Right’s harm reduction program has been operating in Morgantown for six years, said executive director Laura Jones. She describes it as a non-judgmental program, offering services to people who might otherwise have trouble accessing care. The clinic offers plenty of services, like HIV and hep C screenings, case management services and a syringe exchange.
The first time I heard of the idea to supply needles for people to inject drugs, it seemed counterintuitive. Wouldn’t it just make it easier and safer to consume drugs?
Well, that’s kind of the idea.
“People will inject drugs regardless of whether or not they have a clean syringe,” Jones said. “There is no evidence that this enables drug-related behavior. People don’t wake up one day and decide to go run down to the local syringe exchange, get some syringes and start using heroin.”
Reusing or sharing needles leads to deadly diseases, like hepatitis B and C and HIV. When our goal is to make sure people recover from addiction, the first step is to keep them alive. And with such a concerning HIV outbreak in the state, having clean needles is more important than ever.
The initial shock I had when hearing about a needle exchange is a result of stigma. Stigma around drug use runs deep and it’s seeped into our politics. As of April of this year, Gov. Jim Justice has signed into law a bill that makes SSPs harder to access for those in need of needles.
According to Laura Jones, the new bill is a result of the stigma that surrounds drug use. “A lot of rhetoric that we heard at the Legislature for this bill was related to a very negative image that people have of people who use drugs,” she said. “You know, one of the very first people who came to our program was a grandmother who showed us pictures of her grandchildren. She had a job.” There’s a very negative perception of drug users, Jones said, and it’s often not true.
Part of this bill will introduce a “one-to-one” needle exchange, meaning a person must bring in a used needle to the clinic in order to receive one clean needle. Ideally, a system this simple would work perfectly. But as Jones said, it’s not that simple.
“From an outsider’s point of view, that might make perfect sense,” she said. “From the understanding of addiction, that’s not an adequate way of doing business. The CDC and the World Health Organization both recommend need-based programs.”
Jones said lack of transportation in West Virginia poses serious problems for the syringe exchange. “A lot of people have trouble getting here,” she said. “So what we’ve done in the past is we’ve given people syringes and supplies to one person who then gives them to someone else back in their home community. That practice has to stop with this new bill; we can only give syringes to people who can actually come to the clinic.”
Besides the new one-to-one policy, the new bill also requires those coming to the clinic to have a West Virginia ID. Jones said that due to all the borders we share in West Virginia, the harm reduction program has frequently seen people from Pennsylvania, Maryland and Ohio. And because of the close proximity of West Virginia University, the clinic has seen many out-of-state students as well. “People don’t always stay within the borders of their state.”
And, of course, diseases don’t always stay within the borders of their state.
Jones suspects the new law is a result of people concerned about finding used needles in the community, worried about the danger it might pose to accidentally come in contact with a used needle. The harm reduction program has a solution for that, too. By calling or texting the number for the harm reduction program, someone will come collect the needle and safely dispose of it.
Jones weighed in on why Charleston and Huntington’s have concerning HIV outbreaks while Morgantown does not. She credits the success of the harm reduction program. “Increasing syringe access is actually a benefit to a community and speaks to why Morgantown does not have the kind of problems they are seeing with HIV increases in Charleston,” she said.
Needle services are part of what’s called “harm reduction,” and this illustrates why they can be helpful. While the syringe exchange gets people in the door, the clinic offers plenty of services, like HIV and hep C screenings, case management services and other social service programs. That can include, eventually, treatment for substances misuse.
There are ways you can prevent HIV transmission, like using condoms during sex and/or getting a PrEP (pre-exposure prophylaxis) prescription. It is also incredibly important to use clean, sterile needles if you are injecting drugs.
The only way to know if you have HIV, the only way to get treatment, is to first get tested. The theme for this year’s NHTD is “My Test, My Way.” Getting tested for HIV is the first and most important step we can all take to stop HIV deaths. HIV testing is now easier than ever, so let’s explore some options.
You can get tested for HIV and other STDs for free at Monongalia County Health Department and receive free treatment should your test come back positive. Call 304-598-5119 to make an appointment.
The CDC recommends everyone ages 13-64 get tested for HIV at least once in their lifetime. If you have multiple partners and/or inject drugs, you are at higher risk and should get tested more often. You can discuss this with a health care provider.
This National HIV Testing Day, take that important first step so we can end this epidemic together.