In the last 18 months, Oregon’s Multnomah County has reported 42 new HIV cases among people who use drugs, an alarming jump from a total of 25 cases seen among this population in 2016 and 2017 combined, reports Oregon Live. The recent increase follows a five-year decline in HIV rates.

Multnomah County is home to six cities, including the state’s largest city, Portland.

At a press conference last week, county deputy health officer Jennifer Vines, MD, MPH, suggested the new HIV cases were linked to the use of injection drugs and methamphetamine, which is a risk factor for HIV transmission both via drug-fueled sex as well as, when injected, the sharing of needles.  

Health officials said the cases included heterosexual women and men as well as men who have sex with men. What’s more, nearly half of them had tested HIV negative in the past two years, meaning that these new cases represent recent transmissions.

“We don’t know yet if this is a short-term increase or longer-term trend,” Vines said. “The hope is that more testing will link people to the care they need and stop the spread to others.”

At the press conference, Vines outlined plans to suppress future HIV transmissions. These included: 

  • Encouraging health care providers, homelessness nonprofits and social service organizations to refer at-risk people for HIV testing;

  • Making HIV testing more financially and geographically accessible;

  • Raising awareness of the HIV-prevention medication PrEP;

  • Funding harm reduction services such as the creation of syringe exchange sites.

Though the spike is alarming, it was not entirely unexpected, officials said. Rates of syphilis, gonorrhea, shigella and hepatitis C infection in Multnomah County have been rising steadily for the past few years, trends that often foreshadow a similar uptick in HIV rates.

Oregon joins Ohio, West Virginia, Massachusetts and Washington in reporting a recent rise in HIV cases.