Tuesday, January 22, 2019

HIV Clusters Continue to Occur in Northern Kentucky, Cincinnati Region

Health Departments Share CDC Recommendations to Address HIV Among People Who Inject Drugs

Announcement one year after cluster investigation 


Greater Cincinnati/Northern Kentucky — Hamilton County Public Health (HCPH), Northern Kentucky Health Department (NKY Health), Ohio Department of Health (ODH), Kentucky Department for Public Health (DPH) and Centers for Disease Control and Prevention (CDC) have been working together since early 2018 when public health officials identified an increase in HIV infections among people who inject drugs (PWID) in the region. A CDC Epi-Aid team was requested to help respond to this complex public health problem.

Key preliminary findings of the team include:

·         HIV is being transmitted rapidly among networks of PWID between the Northern Kentucky and Cincinnati metro region. Although many cases were diagnosed early in illness, some had advanced disease at the time of diagnosis.

·         New HIV diagnoses continue to occur, without any evidence of decline.

·         Sharing and reuse of needles and injection equipment among PWID exists and drives increases in HIV and hepatitis. Therefore, opportunities are needed to increase accessibility of syringe services programs to prevent disease.

·         Mental health issues and stigma are barriers to receiving services for HIV, substance use, housing and other supportive services.

·         Missed opportunities for earlier HIV diagnosis were found. The majority of HIV-infected PWID had at least one medical visit where they could have found out their HIV status sooner had they been tested at that visit.


Based on the investigation, the CDC made the following recommendations:

·         Improve comprehensive syringe services program delivery to increase uptake of prevention and treatment services and reduce infection risk by removing barriers to access.

·         Expand HIV testing in jails and emergency departments (especially for patients with injection drug use related visits).

·         Improve coordination between HIV testing, HIV care, mental health, and substance use treatment and expand housing and supportive services.

·         Continue efforts to share and integrate data across the involved KY and OH local and state health departments.


“The CDC team took a deep dive into our data and helped us unify it across state lines, giving us a clear picture of the regional issues,” said HCPH Commissioner Tim Ingram.  “We appreciate their collaboration and expertise and look forward to continuing work with our colleagues throughout Southwest Ohio and Northern Kentucky to reduce cases of HIV.”

 “The Epi-Aid team helped identify additional strategies to reach people who inject drugs so that we can reduce the spread of HIV in our region,” said Dr. Lynne Saddler District Director of Health for NKY Health.  “We will share these results with our community partners and will work to carry out the CDC’s recommendations to more effectively help people who inject drugs who live in our communities.”

“The assistance and expertise of the CDC has been a tremendous help to our ongoing work in the Greater Cincinnati area and our efforts to combat the spread of HIV,” said Dr. Jeff Howard, Commissioner of DPH.  “The team provided several recommendations to address ways to better find and test cases among injection drug users, how to more actively engage HIV cases in care, and ways to reduce the risk of ongoing transmission. We are very grateful for their efforts.”

“Partnerships among local, state and federal agencies are integral in solving public health issues,” said Lance Himes, Director of the ODH.

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