HIV outbreaks among people who inject drugs in Europe, North America, and Israel

Don C Des Jarlais; Vana Sypsa; Jonathan Feelemyer; Adrian O Abagiu; Vic Arendt; Dita Broz; Daniel Chemtob; Carole Seguin-Devaux; Joan M Duwve; Margaret Fitzgerald; David J Goldberg; Angelos Hatzakis; Raluca E Jipa; Eugene Katchman; Eamon Keenan; Ibrahim Khan; Stephanie Konrad; Andrew McAuley; Stuart Skinner; Lucas Wiessing

doi:10.1016/S2352-3018(20)30082-5

HIV outbreaks among people who inject drugs in Europe, North America, and Israel

Lancet HIV. 2020 Jun;7(6):e434-e442. doi: 10.1016/S2352-3018(20)30082-5.

Authors

Don C Des Jarlais¹, Vana Sypsa², Jonathan Feelemyer³, Adrian O Abagiu⁴, Vic Arendt⁵, Dita Broz⁶, Daniel Chemtob⁷, Carole Seguin-Devaux⁸, Joan M Duwve⁹, Margaret Fitzgerald¹⁰, David J Goldberg¹¹, Angelos Hatzakis¹², Raluca E Jipa⁴, Eugene Katchman¹³, Eamon Keenan¹⁰, Ibrahim Khan¹⁴, Stephanie Konrad¹⁴, Andrew McAuley¹⁵, Stuart Skinner¹⁶, Lucas Wiessing¹⁷

Affiliations

¹ College of Global Public Health, New York University, New York, NY, USA. Electronic address: don.desjarlais@nyu.edu.
² Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece.
³ College of Global Public Health, New York University, New York, NY, USA.
⁴ National Institute for Infectious Diseases, Bucharest, Romania.
⁵ Service National des Maladies Infectieuses, Centre Hospitalier de Luxembourg, Luxembourg, USA.
⁶ Centers for Disease Control and Prevention, Atlanta, GA, USA.
⁷ Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Israel; Faculty of Medicine, Hebrew University-Hadassah Medical School, Braun School of Public Health and Community Medicine, Jerusalem, Israel.
⁸ Department of Infection and Immunity, Luxembourg Institute of Health, Esch sur Alzette, Luxembourg.
⁹ Richard M Fairbanks School of Public Health, Indianapolis, IN, USA.
¹⁰ Health Services Executive, Dublin, Ireland.
¹¹ NHS National Services Scotland, Glasgow, UK.
¹² Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece; NHS National Services Scotland, Glasgow, UK.
¹³ Infectious Diseases Unit, Tel Aviv Sourasky Medical Centre and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹⁴ First Nations and Inuit Health Branch, Indigenous Services Canada, Regina, SK, Canada.
¹⁵ NHS National Services Scotland, Glasgow, UK; School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
¹⁶ College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
¹⁷ European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal.

Abstract

During 2011-16, HIV outbreaks occurred among people who inject drugs (PWID) in Canada (southeastern Saskatchewan), Greece (Athens), Ireland (Dublin), Israel (Tel Aviv), Luxembourg, Romania (Bucharest), Scotland (Glasgow), and USA (Scott County, Indiana). Factors common to many of these outbreaks included community economic problems, homelessness, and changes in drug injection patterns. The outbreaks differed in size (from under 100 to over 1000 newly reported HIV cases among PWID) and in the extent to which combined prevention had been implemented before, during, and after the outbreaks. Countries need to ensure high coverage of HIV prevention services and coverage higher than the current UNAIDS recommendation might be needed in areas in which short acting drugs are injected. In addition, monitoring of PWID with special attention for changing drug use patterns, risk behaviours, and susceptible subgroups (eg, PWID experiencing homelessness) needs to be in place to prevent or rapidly detect and contain new HIV outbreaks.

Publication types

Research Support, N.I.H., Extramural
Review

MeSH terms

Disease Outbreaks*
Europe / epidemiology
Female
HIV Infections / epidemiology*
Health Services Accessibility / statistics & numerical data
Humans
Ill-Housed Persons / statistics & numerical data
Israel / epidemiology
Male
North America / epidemiology
Socioeconomic Factors
Substance Abuse, Intravenous / epidemiology*

Grants and funding

R01 DA003574/DA/NIDA NIH HHS/United States