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For the month of June, the Centers for Disease Control and Prevention is in Kanawha County to assess the current HIV outbreak.
The CDC’s short-term investigation and assistance, known as an Epi-Aid, involves boots on the ground interviews and data analysis. A final report on its findings and recommendations is expected in July.
Anywhere from five to 10 people are hitting the streets of Charleston, interviewing and helping people who inject drugs. These people are most at risk of getting and spreading HIV. In 2021, 16 new cases have been detected in the county. Of those, 12 were among those who inject drugs.
The CDC intends to interview dozens of these people who have or are at risk of getting HIV, said Dr. Sherri Young, director of the Kanawha-Charleston Health Department at an HIV Task Force meeting Tuesday. The group meets monthly. She said the CDC will also interview stakeholders like health and social service providers.
“This is to see how we can better assist [clients], and see what services and interventions we can do to help them as well,” Young said.
The CDC is also analyzing health records to learn when HIV-positive people interact with local health providers, and what ailments they’re experiencing during these visits. Most new cases of HIV in the county are being detected in hospitals when someone has a medical emergency, according to Shannon McBee, a state epidemiologist.
While federal workers are in town for a short time, they are working hand-in-hand with local partners who have been tackling this issue for years, and who are continuing to rethink their practices.
The Charleston-Kanawha Health Department began mobile HIV testing two times a week in April. So far that program has detected three new positives in the county. These aren’t large scale testing events. Instead they are meant to target those most at-risk.
“When you have HIV and they collect your information, we look at zip codes. And so we can identify down to the zip code pretty closely where people are,” Young said.
The program has also reconnected nine HIV-positive people back to the healthcare system.
State data shows among new HIV cases in the past two years in Kanawha County, a quarter have never sought treatment. Those who are struggling with addiction and insecure housing can have a difficult time making appointments and sticking to a medical routine, said Dr. Christine Teague of the Ryan White Foundation at CAMC.
“I want to do everything that I can do for that person. Right now I want to take care of them,” she said. “But we have to be patient, because it may take weeks, months, to get them to that point.”
Teague said her program hopes to streamline the process of medical intake. She said this is essential for those who may be intimidated by a big hospital complex, or who fear a long wait time could send them into withdrawal.
Teague and other health and social service providers think the opening of the new Health Right Clinic on the West Side will improve access. The free clinic operates a syringe service program and distributes PrEP, or pre-exposure prophylaxis. It’s a medication taken daily to prevent someone from contracting the virus. While the medication is most effective at preventing the sexual transmission of HIV, it is 74 percent effective for those who use IV drugs, according to the CDC. Director Angie Settle said the CDC has already helped get three clients on PrEP through her clinic.
Settle said these clients can lose their medications or they get stolen. That’s why she’s working on methods to give clients single doses.
“To actually get out in the field and have like a set route, where we would actually be able to go daily,” Settle said.
The barriers for those who have an addiction and no housing are immense, said Cassie Province, a case manager for Covenant House, which offers housing to almost 50 people in Charleston.
“When they come to us, they’ll say, well I thought I already had it,” she said. “These are the most vulnerable clients. This is the one that we continuously test every two weeks if we can, three weeks, just to keep a rapport with them, because we’ll lose them if we don’t talk to them weekly.”