Undoubtedly, one reason for the notice is that it stands in stark contrast to a long-term trend. Indeed, the drop in injection drug use-related HIV has been one of the unheralded success stories in the USA HIV epidemic.<\/p>\n
Once a very prominent “transmission category,” it has declined more than any other risk factor, now accounting for less than 10% of new HIV diagnoses per year.<\/a> For a broader view, here are AIDS cases in the USA since the beginning of the epidemic, showing the steady decline in cases attributable to injection drug use since the mid-1990s:<\/p>\n This decrease in cases is even more remarkable when viewed in the context of our national opioid epidemic, a problem we ID doctors are reminded of on a daily basis — not from HIV, but from serious invasive bacterial infections<\/a> and, to a lesser extent, hepatitis C.<\/p>\n By contrast, new cases of HIV due to injection drug use alone are now relatively uncommon in the United States.\u00a0A notable recent exception was the 2015 Indiana HIV outbreak<\/a>, where nearly 200 new HIV infections occurred in four months in a rural community hard-hit by opioid addiction.<\/p>\n A skillful CDC investigation found that just one person<\/em> with HIV was the source of the outbreak, which was then fueled by a needle-sharing network. The outbreak\u00a0demonstrated the potential rapid spread of HIV in this population — and then the ability of syringe exchange programs to control it.<\/p>\n Are we seeing the beginning of something like the Indiana outbreak now in Massachusetts? Or is this year’s increase — admittedly rather small to date — just a temporary blip?<\/p>\n Regardless, good work by the MDPH in getting the word out — vastly preferable to be early rather than late to recognize this trend.<\/p>\n I’ve heard anecdotally there might be other HIV outbreaks nationally among people who inject drugs. What’s been your experience where you practice?<\/p>\n![\"\"](\"https:\/\/blogs.nejm.org\/hiv-id-observations\/wp-content\/uploads\/sites\/2\/2017\/12\/cdc-hiv-surveillance-genepi-2016__Read-Only_.jpg\")
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