In 2015, 74 adolescents and adults were diagnosed with HIV in West Virginia (WV), while the state ranked 40th in the USA regarding the number of HIV diagnoses within the 50 states. By the end of 2016, as per the state's HIV surveillance report 2017, an estimated 1,746 individuals were living with HIV in WV. By 2018, this number increased to 1,891, while 86 people were diagnosed with the virus in WV that year. Nearly 28 WV counties were declared to be at risk of or experiencing an HIV outbreak.
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The Centers for Disease Control and Prevention (CDC) reported that around 1.2 million American citizens were living with HIV in 2017-18, and about 161,800 of them were unaware of their status. Around 40% of new HIV infections were transmitted to others by people who didn't know they had contracted the virus. Hence, for anyone sexually active, getting tested for HIV should be the primary step to maintain a healthy life and prevent HIV transmission.
West Virginia, as mentioned above, is experiencing a sudden HIV outbreak. Therefore, it becomes imperative for people to make HIV testing a mandatory part of their annual health checkup. CDC recommends that individuals between the ages 13 and 64 get tested for HIV when they undergo routine health care, and those at higher risk should get tested at least once a year.
As per a study sponsored by the National Institutes of Health, people diagnosed with HIV early and start the treatment right away are at a clear health advantage compared to those diagnosed at a later stage of HIV. People aware of their health status can immediately start antiretroviral therapy, a potent HIV treatment, and have a healthy life.
The sooner the treatment is initiated after HIV diagnosis, the longer life the infected person will enjoy. Antiretroviral therapy reduces the viral load, which is the HIV amount in the blood, prevents the virus's transmission to others, and reduces the person's vulnerability to other HIV-related illnesses.
The West Virginia Division of STD & HIV provides surveillance, testing, intervention, education (S.I.T.E) and health care services to prevent/control the spread of HIV in WV. The division is required to monitor the HIV epidemic, ensure improvement in public awareness of HIV, prevent/reduce risk behaviors that result in HIV transmission, ensure a secure and quality system for HIV/AIDS surveillance and that all at-risk population groups are aware of their serostatus.
Under the Part B of the Ryan White HIV/AIDS Treatment Extension Act of 2009, the state of West Virginia receives grants to improve the quality and availability of HIV health care and support services. The WV Ryan White Part B Program also conducts/supports medical case management for qualified HIV infected WV residents. Through the program, nearly 1,300 WV residents are served annually.
Ryan White Part B program works in close collaboration with other Ryan White funded programs as well as private providers to offer coordinated client services and prevent duplication of efforts. The department makes sure people living with HIV have access to quality care and remain in HIV primary care.
In 2018–2019, WV recorded an unexpected and rapid rise in new HIV diagnoses among people who inject drugs. The WV Bureau for Public Health, community partners, CDC, and local health departments have collaborated to take decisive action to bridge the gaps in HIV care and prevention services.
As many as ten Syringe Services Programs (SSPs) are operating statewide to address the growing trend of drug injection. SSPs are community-based prevention programs offering a range of services such as linkage to substance abuse disorder treatment, access/disposal of sterile syringes/injection equipment, vaccination testing, and linkage to care. Furthermore, the program ensures people can access treatment for infectious diseases.
Recently, Republican Governor Jim Justice signed a bill to implement stricter guidelines for needle exchange programs to address the spike in HIV cases across the state. The bill will make it mandatory for distribution and syringe collection programs to acquire licenses. Operators will have to offer a broader range of health outreach services, such as overdose prevention education and/or substance abuse treatment program's recommendations. Participants will also show an identification card to obtain a syringe.
By legislative rule, AIDS became a reportable disease in WV in April 1984, and HIV became reportable in the state in September 1989.
In 2017 WV had the country's 35th highest rate of new HIV diagnoses, and 55% of the residents were found to be virally suppressed, and 88% of people with HIV in the state were declared aware of their health status indicating that approx. 245 people per 100,000 population couldn't get the care they required. Across the state, around 3,947 HIV tests were offered in WV.
According to the 2018 HIV statistics, the state reported 86 new HIV diagnoses. The percentage of males was higher than females, with over 78% and 21.3% of all new HIV cases, respectively.
As per the state's HIV Surveillance Report 2017, the top five WV counties that reported the higher rate of new diagnoses during 2012-2016 were Kanawha, Raleigh, Cabell, Berkeley, and Monongalia.
The state health department identified that HIV prevalence was higher in major urban areas such as Martinsburg in Berkeley County, reported 213 cases/100,000 population, followed by Charleston in Kanawha country, which accounted for 171 cases/100,000 people, Huntington in Cabell County reported 166 cases/100,000 people, Beckley in Raleigh County had the most cases with 158/100,000 people. Morgantown in Monongalia County reported 127 cases/100,000 people.
By 2014, just 12.5% of all HIV cases in WV resulted from intravenous drug use, and by 2019, this rate increased to over 64%, according to the state health department. This spike was mainly noted in Cabell and Kanawha counties. The West Virginia Bureau for Public Health (BPH) noticed an upsurge in HIV diagnoses among people who inject drugs in January 2019, and the largest proportion of the cases was noted in Cabell County. The CDC, BPH, and Cabell-Huntington Health Department collectively conducted a robust investigation and identified that from an annual average of 2 cases in 2015-2017, HIV prevalence among people who inject drugs had increased to 81 cases, marking a 2,285% increase in 2018-19.
According to AIDSVu, in WV, of all the people living with HIV, around 77.8% were males, and 22.2% were females in 2018. This proportion was rather varied for people of color as whites accounted for the highest percentage of HIV-infected individuals with over 67% of all reported cases in 2018, followed by African-Americans with over 20% of all cases, and Hispanics with 5.2% of all diagnoses.
Age-wise, the worst affected group was people above 55 years with more than 36% of all cases, followed by 45-54 age group that reportedly accounted for around 30% of HIV cases statewide, and the third most impacted group was people aged 25-34 with close to 20% of all cases.
Since WV is experiencing an unexpectedly high HIV outbreak among people who inject drugs, according to the state's health department data, most of the cases were identified in males (58%) and out of these, 74% of the cases were diagnosed in people aged 20-39 years. Out of these cases, 91% were diagnosed in whites, and 85% inferred transmission in early 2018. The estimated transmission rate was 78 cases/100,000 people.
The rate of HIV cases tied to drug use has been increasing in Kanawha since 2018 as from two in 2018, the number of cases increased to 15 in 2019. By 2020, as many as 35 cases were reported in WV, followed by 41 in 2021, as per the data shared by the West Virginia Department of Health and Human Resources.