CDC identifies 220 US counties most vulnerable to outbreaks of HIV and hepatitis C

The Kentucky Health News reported that the Centers for Disease Control and Prevention (CDC) has come up with a preliminary report that identified 220 counties in the US that are facing the highest risk of HIV and hepatitis C outbreaks among those who inject drugs in the communities.

Among them, 54 belong to Kentucky and two are located in the Buffalo Trace Area. Robertson County has been ranked 175th and Lewis County is on 178th rank.

Allison Adams, Buffalo Trace Health District executive director, said that there are minimal two factors that could contribute to the ranking of Robertson County. They are a small population to measure any incidence against and insufficient health care.

Health Department Executive Director Anita Bertram in Lewis County said that the numbers didn’t surprise her, while admitting that her county wasn’t the only one facing a rise in IV drug use. According to her, Lewis County doesn’t have a monopoly on drug users.

According to the CDC, in terms of rate of acute hepatitis C, Kentucky leads the nation with 4.1 cases for every 100,000 residents, over six times the national average.

Adams also said that she has noticed a rise in HIV and hepatitis C in the last some years. Adams added that they weren’t any different from the state, which has noticed an increase in the last half decade as a whole. She said that the numbers are likely to ‘skyrocket’.

While speaking to Kentucky Health News, Doug Hogan, acting communications director for the Cabinet for Health and Family Services, said, “Both HIV and hepatitis C can be transmitted when people who inject drugs share their needles. Many of Kentucky’s HCV cases are among rural youth, ages 12-29, who have been sharing needles”.

“But in Washington, D.C., black heterosexual women represent the second-highest demographic of new HIV infections, after black men who have sex with men. One in every five HIV diagnoses comes from a black woman in D.C., a city that’s been battling the country’s highest HIV rate for many years,” according to a news report published by Slate.

The investment is part of D.C. Mayor Muriel Bowser’s tongue-twister of a new HIV-prevention plan, “90/90/90/50 by 2020,” which she first announced last summer. The plan seeks to ensure that 90 percent of D.C. residents with HIV know their status; 90 percent will be in treatment, 90 percent will reduce their viral loads to undetectability, and that D.C.’s new infection rate will drop by 50 percent.

In 2009, D.C. declared an HIV epidemic that rivaled those in many African nations, with around 3 percent of the city’s residents living with HIV. In some areas and age groups, it was closer to 5 percent. Though targeted prevention efforts have cut D.C.’s new-diagnosis rate by almost 60 percent since then, the city still has an HIV rate nearly twice as high as the state with the next highest rate, Louisiana, and nearly 4 percent of black residents are infected. In D.C. and across the country, HIV is a racialized epidemic among women: As of 2012, 92 percent of D.C. women living with HIV were black.

According to a story published on the topic by Maysville, “A preliminary report by the Centers for Disease Control and Prevention has identified 220 counties in the United States as most vulnerable to outbreaks of HIV and hepatitis C among those who inject drugs in those communities, according to the Kentucky Health News.”

At least two factors may contribute to Robertson County’s ranking, said Allison Adams, Buffalo Trace Health District executive director. Those include a small population to measure any incidence against and the lack of availability of health care.

“Both HIV and hepatitis C can be transmitted when people who inject drugs share their needles,” Doug Hogan, acting communications director for the Cabinet for Health and Family Services, told Kentucky Health News. “Many of Kentucky’s HCV cases are among rural youth, ages 12-29, who have been sharing needles.”

A report published in Huffington Post informed, “Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention method, currently a one-pill once-a-day regimen, with the potential to dramatically impact new HIV infections. The historic 2015 World Health Organization’s (WHO) early release guidelines on PrEP recommend offering PrEP to individuals at substantial risk as part of a combination of HIV prevention services.”

In order for PrEP to be effective in curbing the disproportionate rates of HIV acquisition among women, clear normative guidance needs to include women’s reproductive health intentions including women who are pregnant and breastfeeding. As countries, clinics and providers grapple with how to best offer PrEP to women throughout their lifetimes, we suggest a strengths-based approach, rooted in trusting women.

PrEP is a disruptive innovation in the HIV prevention dialogue, introducing choice and the possibility for shared decision-making. We have the opportunity to develop a prevention approach responsive to women’s reproductive and sexual preferences and values across a lifetime. Let’s take advantage of it.

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