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Health Activists Implore Charleston Mayor For ‘Proactive’ Help In HIV Fight

Activists in Charleston called on Mayor Amy Goodwin to declare a public health emergency. Some health providers and church leaders say the city needs to better address a cluster of HIV cases as well as the rise in opioid overdose deaths.

At the city’s riverfront park, Magic Island, kids laughed and screamed as they ran through fountains on Saturday. So called “river rats” took their motorboats out on the Kanawha River.

They were all trying to beat the heat. So were a few hundred adults, who gathered at the park’s lawn near Charleston’s West Side, where there were tents offering shade and plenty of bottled water to go around.

The folks here know how to come to the aid of their neighbors. The group was made up of health care workers, peer recovery coaches, faith leaders and parents.

They met on a hot afternoon to send a message to the city that some of Charleston’s most vulnerable are at risk of losing their lives.

“The individuals and the pattern they make up are not someone else’s problem. They are us, and the challenges to their health are our challenges together,” said Rev. Krysta Rexrode Wolfe of Cross Lanes United Methodist Church.

Rev. Krysta Rexrode Wolfe of Cross Lanes United Methodist Church speaks at the HIV SOS demonstration in Charleston.

Opioid overdose deaths spiked in the capital city and state last year. The opioid crisis has led to another serious threat. HIV is spreading among IV drug users.

To send their message home, a few hundred people formed a signal with their bodies on the lawn. Participants spelled out two acronyms HIV SOS. They wore red shirts that say “love breaks through stigma.” A drone hovered above their heads to take aerial shots of the scene.

Protesters gathered at Magic Island in Charleston for an HIV awareness event.

Participants used their bodies to make their message known. Speakers voiced their concerns loudly.

Dr. Christine Teague has been working with HIV and AIDS patients for 20 years with the Ryan White Foundation. She treated many gay men who contracted the virus sexually in the 1990’s. But her clientele has shifted, due to the rampant use of IV drugs.

“We’ve known for several years that our area is very vulnerable to an outbreak. And so that’s exactly what we’ve seen,” she said.

Teague and other health providers saw the need for more testing, before people wound up in the hospital. More testing confirmed her suspicions. Kanawha County saw 44 new cases of HIV in 2020. That’s three times as many the county saw a few years ago.

“I’m here to tell you that that number is going to continue to grow,” Teague said.

Kristina Hutcheson works with HIV prevention programs through the Partnership for African American Churches.

“The main reason we got into doing our HIV program is because black Americans are disproportionately affected by HIV,” said Hutcheson. “We’re 4% of the the population in West Virginia, but we make up 18% of the new HIV cases.”

Ally Fox, a peer recovery coach from Morgantown also spoke. She said harm reduction services at Morgantown’s Health Right clinic saved her life. There, she received clean syringes, overdose reversal medication, and referrals to substance use disorder treatment.

“I can stand in here and say that I am HIV negative, that my child is safe, he is HIV negative. And that is due to two reasons: God’s good graces and Mon County needle exchange,” Fox said.

More than 30 health, faith and social justice groups supported this event, which was organized by Solutions Oriented Addiction Response, or SOAR. Along with their message, the group brought resources to keep people safe.

“We had HIV testing, we had Covid vaccines, we had a fleet of doctors and nurses available for wound care,” said SOAR organizer Joe Solomon.

SOAR also gave out almost 1,000 doses of Narcan that day, which can save the life of someone experiencing an overdose.

The group is used to this kind of work. It hosted fairs that distributed the same products and care at a church parking lot on the West Side. But those fairs stopped, due to public pressure and a city ordinance passed earlier this year. The law says programs like the local Health Right clinic can distribute needles, because it has a brick and mortar location and limits the number of needles it gives out. SOAR gave out needles freely in an open-air setting.

Event participants called on the city to do more, by issuing a local public health emergency. Organizers think a local declaration would garner more attention, promote a sense of urgency, and bring more public resources to the table.

“From day one our administration has been focused on comprehensive solutions to the drug crisis and the harm that’s associated with it,” Goodwin, who is Charleston’s mayor, told West Virginia Public Broadcasting.

Goodwin was the one to request a team from the Centers for Disease Control and Prevention to investigate the local HIV outbreak, even when state health officials said it wasn’t necessary.

“That includes solutions that are community-led, community-focused and most important community-supported,” Goodwin said.

SOAR criticized the city for passing a law that limits the dispersal of clean needles.

One council member stood with demonstrators on the day of the protest. Robert Sheets represents a ward in the East End. He was the one council member to vote against that local ordinance.

“I thought there were a few others that would have voted no, and I think they would have, but as the vote went on and on everyone just acquiesced and gave in,” he said.

When other members said these unlicensed syringe programs were flooding communities with needle litter, he suggested more syringe disposal containers in the city, not a shutdown of these programs.

“We need to be proactive in our efforts,” he said. “Not reactive, proactive.”

Charleston Activists Call For Local Health Emergency

Charleston activists are set to hold a demonstration this weekend that they are calling an SOS. Their plea is for Charleston Mayor Amy Goodwin to declare a local public health emergency concerning the spread of HIV, and the increase in opioid overdoses.

“All we’re asking for is the city to acknowledge the crisis we’re in, so we can face it head on. It’s well within the Mayor’s power to declare a public health emergency,” said Cathy Kunkel in a news release, one of the organizers of the demonstration, in a news release.

The two public health crises are intertwined. Most newly diagnosed HIV cases in Kanawha County are among those who inject IV drugs. Those in the community who operate harm-reduction programs have tried to curb the spread of HIV transmission through sterile syringe programs and regular HIV testing. They also offer Naloxone, an overdose reversal drug, and referrals to substance use disorder treatment as well.

More than 200 people died from an opioid overdose in Kanawha County last year. That’s about a 30 percent increase from 2019, a trend that’s reflected across the whole state.

The Centers for Disease Control and Prevention has said Kanawha County faces the “most concerning” HIV outbreak in the nation.

More than 30 health and social justice organizations are participating in the demonstration, with speakers from the Partnership of African American Churches and the Ryan White Foundation.

Solutions Oriented Addiction Response, or SOAR, organized the event. The grassroots group had been organizing health fairs that gave out sterile syringes. The group stopped those fairs due to public pressure and a city ordinance restricting syringe dispersal.

Demonstrators will gather at a riverfront park known as Magic Island from 2 p.m. to 4 p.m. this Saturday.

CDC Wraps Investigation Of Kanawha County HIV Crisis

The Centers for Disease Control and Prevention has wrapped a month-long investigation into the growing HIV crisis in Kanawha County.

After the federal health agency called Charleston’s HIV outbreak the “most concerning in the nation” this year, it offered to help. That came in the form of an Epi-Aid, a short-term but highly involved assessment and assistance. The CDC spent four weeks in June in the capital city to figure out what more local and state health officials can do to slow the spread of HIV.

Federal health workers went out to the streets to interview IV drug users. These people are most at risk of contracting the disease. Almost 75 percent of newly diagnosed HIV cases this year are among people who inject drugs.

The CDC found people often don’t have access to clean needles, which helps prevent the spread of disease caused by needle-sharing, according to a release from the state Department of Health and Human Resources.

The local health department shut down a syringe services program in 2018. Another volunteer, grassroots program came along, but has since stopped its health fairs. Organizers said they stopped the program due to public pressure and a city ordinance tightening restrictions on syringe services. One needle exchange operated by the free clinic Health Right remains in Charleston.

The CDC found many IV drug users said they distrust or are intimidated by the healthcare system. That might explain why most people newly diagnosed with HIV don’t seek out routine treatment.

The CDC found more testing can be done with at-risk groups and in healthcare settings. State data says most new cases of HIV are detected in acute care settings.

The local health department implemented mobile, targeted HIV testing earlier this year. But Kanawha-Charleston Health Department Director Dr. Sherri Young said more can be done.

“We’re looking at ways to expand access to PrEP therapy and to increase HIV testing before individuals present in an acute care setting,” Young wrote.

The CDC’s initial findings were presented to local health providers and the state. The CDC’s full report will be published and available to the public in August.

The state DHHR says the meeting was not open to the public or reporters because the data collection and analysis is still ongoing.

Activists in Charleston are calling on Mayor Amy Goodwin to declare a local public health emergency due to the HIV outbreak.

CDC's Report On Kanawha HIV Outbreak Expected In July

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.”

CDC Brings Forces to Kanawha County During HIV Crisis

Kanawha County has the most alarming HIV outbreak in the nation, according to the Centers for Disease Control and Prevention. But Tuesday, a small team from the CDC arrived in the capitol city to figure out what more could be done to stomp out this growing epidemic.

In February, the CDC offered to help. With a push from Charleston Mayor Amy Goodwin, the state requested an “Epi-Aid” — an investigation followed by rapid, short-term assistance.

In April, the CDC sent two specialists to Charleston for a three-month term. Now, the CDC is sending reinforcements — a team of five to nine people will work in Charleston for four weeks, along with a host of experts working remotely.

“This will enhance our efforts, we welcome the Epi-Aid, and we are very thankful that the state helped us in getting that from the CDC,” said Dr. Sherri Young, director of the Kanawha-Charleston Health Department. She made her request to the state after hearing from the mayor.

Kanawha County is not the first to receive an Epi-Aid. In 2019, when Cabell County, West Virginia, documented 69 new cases of HIV, the CDC quickly came to help.

“There were a lot of people on the ground here,” said Dr. Michael Kilkenny, the CEO and health officer of the Cabell-Huntington Health Department, who says the CDC offered critical assistance to his department’s efforts.

Nearly all of the new HIV cases in Cabell County were caused by intravenous drug use and needle sharing. The county had a syringe service program already, but the CDC said it needed to be bigger, and the county health department and local officials took their advice.

“Everybody just pulled together to offer all of the resources or all of the services that were going to help,” Kilkenny said.

Kilkenny was amazed by how CDC specialists could gain the trust of IV drug users — many of whom are homeless — so quickly.

“They’re not from around here, but they’re so well-trained, that they could talk to anybody, probably anywhere in the world,” he said.

New cases dropped — from 69 in 2019, to 40 in 2020, and less than 10 so far this year. Kilkenny knows it’s not over, but he says without the CDC, the outbreak might have never gotten under control.

Now, Charleston is facing a similar crisis. The county has identified 89 new HIV cases since 2019 — 66 of those among IV drug users.

Dr. Christine Teague has worked with people who are HIV-positive for 25 years. In the past, she says her patients at the Charleston Area Medical Center’s Ryan White Foundation were relatively stable, with secure housing and some income. But things have changed.

Now, her patients are among the most vulnerable in society, struggling with addiction and homelessness.

“It’s just basic survival and accessing drugs so that they won’t go into withdrawal and become sick,” Teague said.

For people in such dire straits, preventing or treating HIV can be a low priority. And many of the folks who are turning up HIV positive don’t have mailing addresses, cell phones, or reliable transportation. Others are intimidated by visiting a big hospital complex, Teague said.

“We had one lady who didn’t want to come into an appointment a couple weeks ago, because she hadn’t been able to shower in two weeks, and she was embarrassed,” she said.

Teague said comprehensive HIV treatment is available, but it takes consistency to work.

Ultimately, Teague and others hope that the additional expertise will lead to more testing, treatment, contact-tracing and prevention specific to Charleston’s circumstances.

If the dwindling HIV numbers in Cabell County are any indication, Charleston may be on its way to finding some relief from the worst of the crisis.

“We all have to collaborate together,” Teague said. “The CDC will come in and study the situation and give us some guidance on how we can best move forward as a community.”

Kanawha Commissioners Question HIV Label For The County From CDC

Kanawha County Commissioners have requested a Congressional inquiry into statements that the county has the “most concerning” HIV outbreak in the country.

A presentation by a Centers for Disease Control and Prevention (CDC) employee to the Kanawha-Charleston Health Department and the West Virginia Congressional Delegation raised the initial alarm.

Commissioners sent a letter to U.S. Sen. Joe Manchin and he in turn sent a letter to CDC Director Dr. Rochelle Walensky asking for clarification. They want to know if the CDC has completed an official investigation and who determined the situation in the county was the most concerning.

The original presentation said there were 51 cases of HIV in the county since January 2019 and 35 in 2020 alone.

In his letter, Manchin said: “I am submitting a formal congressional inquiry for your prompt response. Given the pressing public health nature of the issue, I request that your staff review the enclosed concerns and contact the Kanawha County Commission no later than Friday, April 9th.”

The original letter from the county commission asked several questions including: “Has the CDC completed an official investigation into the rise in HIV cases? If not, why not?” and “Is the rise the most concerning in the United States of America?”

They raised concerns of the determination being made without factual or empirical evidence, and asked if there was a peer-reviewed, evidence-based finding that would support the “alarming allegation.”

You can read the letter from the Kanawha County Commission to Manchin here. And Manchin’s letter here.