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Ohio Valley Public Health Agencies Take Proactive Look at HIV

More counties trying needle-exchange idea

WHEELING — With a recent spike in newly diagnosed cases of human immunodeficiency virus in southern West Virginia, public health agencies are stepping up efforts to prevent similar HIV outbreaks in the Northern Panhandle.

Statistics for new HIV cases in the six northern counties are not available, but health officials believe the numbers are small.

Regardless of the actual numbers, they said, the threat remains constant and agencies continue to be vigilant in trying to prevent infection.

Howard Gamble, administrator of the Wheeling-Ohio County Health Department, cautioned, “In any jurisdiction in the state of West Virginia or region of Appalachia, the chance of an HIV outbreak is very great.”

Dr. Rahul Gupta, commissioner of the West Virginia Bureau for Public Health, was unavailable for comment on the HIV outbreak in southern counties or to discuss county-by-county cases of HIV.

Toby D. Wagoner, the bureau’s public information officer, said, “We do not release the HIV data by county due to small numbers in an effort to protect the confidentiality of the patient(s). However, we publish cumulative data, and data by district.”

West Virginia’s 2017 HIV/AIDS Surveillance Report listed 1,091 cases of HIV reported in the state from September 1989 through December 2016. The numbers include only people who have been diagnosed with HIV, but not diagnosed with AIDS.

The report indicates that 1,746 people in West Virginia were living with HIV and AIDS in 2016. The number excludes federal prisoners.

According to this report, 101 people were living with HIV and AIDS in 2016 in the state’s District 6, which encompasses Hancock, Brooke, Ohio, Marshall and Wetzel counties.

For the same period, 122 were living with HIV and AIDS in District 5, which includes Tyler and seven other counties.

Gamble said the number of HIV diagnoses is so small that state officials release a year’s worth of data reported in clusters or geographic areas.

In Ohio County, he said, “We aren’t seeing an overall dramatic increase. The state health department is seeing increases across the state and designated areas where they have more potential for problems. In the Northern Panhandle, the number of individuals diagnosed or living with HIV is low compared to the rest of the state.”

Gamble added, “The state of West Virginia addressed this one particular outbreak (in southern counties) and they have it under control. That doesn’t mean the problem is solved. In any other jurisdiction or district, you could have the same thing occur. With any communicable disease, it doesn’t take much to get additional cases.”

In response to the dangers of HIV and other infectious diseases such as hepatitis C and hepatitis B, needle exchange programs and other harm reduction efforts are being launched throughout the Northern Panhandle.

The longest-running needle exchange program in the region is operated by the Wheeling-Ohio County Health Department, in partnership with Northwood Health Systems. Gamble estimated more than 12,000 clean needles have been distributed since the program began in September 2015.

Participation in the weekly session has increased since its inception two years ago. Gamble said the numbers were small initially, but 300-400 needles are given out at each clinic now. The one-for-one free needle exchange program is open at Northwood, 2121 Eoff St., Wheeling, from noon to 3 p.m. every Friday.

Every participant is given a pamphlet listing names and numbers to call for treatment and addiction counseling. He said, “We have had people interested. … We have had people say they’ve talked to Northwood.”

However, few local needle users have requested testing for HIV or hepatitis C.

“We’ve screened very, very few people for anything. Maybe it will take a while for people to say, ‘I want to be screened or tested.’ Our numbers are extremely low when it comes to that,” Gamble said.

Michael Bolen, administrator of the Brooke County Health Department, said the federal Centers for Disease Control and Prevention previously identified Brooke and Hancock counties within the top 100 counties across the country at greatest risk for HIV or hepatitis.

“We’re definitely concerned about it,” he said.

To combat the threat of infection, Brooke, Hancock and Jefferson counties have formed the Ohio Valley Harm Reduction Coalition. The group has started a one-for-one needle exchange program, Bolen said.

Used needles can be exchanged for new, clean syringes at three locations: Northwood Health Systems, 353 American Way, Weirton, from 1-3 p.m. every Friday; Family Recovery Center, 1010 N. Sixth St., Steubenville, 1-3 p.m. on the first and third Friday of every month; and at the Hancock County Health Department, 100 N. Court St., New Cumberland, 1-3 p.m. every Thursday.

In addition to the obvious health risk that an outbreak poses in a community, infectious diseases carry significant economic impact.

Bolen said the needle exchange operates at a very small cost. He added, “When you look at the cost of an outbreak or even several cases of HIV or hepatitis C, it’s hundreds of thousands of dollars per case. We all pay for that. Whether private insurance or government-assisted insurance, everyone has to pay for that issue.”

For example, Bolen said the lifetime cost of treating a single case of hepatitis C is estimated at $80,000 to $120,000, while the lifetime cost for one case of HIV is approximately $500,000. Thus, a 100-person outbreak would result in considerable cost for “a state that is already struggling economically,” he said.

Jackie Huff, administrator of the Hancock County Health Department, could not be reached for comment on the preventive efforts.

Dara Pond, administrator of the Marshall County Health Department, said, “We’ve had no recent confirmed cases (of HIV). … We are, of course, closely monitoring the situation and working closely with the state.”

Pond said Marshall County has joined a harm reduction coalition and is early in the development of a needle exchange program.

“We do have prevention education available. We offer free condoms, free (sexually-transmitted disease) testing and are able to provide referrals for counseling and treatment,” she said. “We also are working with a women’s regional committee to discuss partnering with our family planning programs and harm reduction to hopefully prevent HIV-infected pregnancies, as well.”

Regarding the potential for an HIV outbreak, Karen Cain, administrator of the Wetzel-Tyler County Health Department, said, “It’s always a threat since we have intravenous drug users. So we are starting a clean needle exchange program after the first of the year.”


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