A Renewed County-by-County Fight Against HIV

President Donald Trump focused part of his State of the Union speech last week on HIV and AIDs, urging a bipartisan approach to “eliminate the HIV epidemic in the United States within 10 years.”

The president said, “Scientific breakthroughs have brought a once-distant dream within reach,” adding that his budget will call on Democrats and Republicans “to make the needed commitment” to eliminate the epidemic.

In-depth details of the plan were not available, but a two-page overview from U.S. Health & Human Services indicates that a key part of the strategy is to focus on 48 counties; Washington, D.C.; San Juan, Puerto Rico; as well as seven states that have a substantial HIV burden.

Last week, Massachusetts DPH sent out an advisory noting that it has detected an increase across Massachusetts in newly diagnosed HIV infections among persons who inject drugs. DPH is asking healthcare providers to enhance their vigilance for, and increase their testing and reporting of new HIV infections.

In 2018, DPH and the federal Centers for Disease Control and Prevention investigated an outbreak of HIV infection attributable to injectable drug use in Lowell and Lawrence. Since mid-November 2018, a small cluster of similar infections has been identified in Boston, and recently in Worcester. “Surveillance data indicate that new HIV infections attributed to [injectable drug use] exposures are increasing statewide,” DPH wrote. From 2014 to 2017, the proportion of new HIV diagnoses in Massachusetts attributable to injectable drug use exposures increased from 5% to 17%.