With HIV outbreaks occurring among people who inject drugs (PWID) around the world, from Bucharest, Romania, to Scott County, Indiana, researchers warn that complacency will add fuel to the fire and raise the risk of further outbreaks, aidsmap reports.

The answer to such threats, such researchers say, is comprehensive services that include syringe services programs (SSPs), opioid substitution therapy (OST) and HIV testing and treatment.

Investigators speaking at the International AIDS Conference in Amsterdam (AIDS 2018) reviewed recent outbreaks of HIV among PWID. The largest such outbreaks occurred in Bucharest and Athens, each of which saw about 1,110 new cases of the virus among local PWID. In Dublin, the annual HIV diagnosis rate rose from about 20 to 57 cases during 2014 to 2015. Glasgow, Luxembourg and Saskatchewan, Canada, have seen similar upticks.

Marginalized groups, such as those without homes (in Athens, Glasgow and Dublin), indigenous people (Saskatchewan) and migrants (Athens), are at particularly high risk of contracting HIV in these outbreaks.

Scott County experienced an outbreak of more than 200 cases of HIV beginning in about mid-2014. The implementation of SSPs, which required an exception from the state government because they are otherwise illegal in Indiana, has been instrumental in bringing the outbreak to heel.

Similar use of such services, along with other HIV prevention interventions, has helped contain other outbreaks, although Glasgow and Saskatchewan in particular have not seen complete success.

The researchers stressed to AIDS 2018 attendees the importance of adapting services to PWID to provide responses tailored to changing drug use patterns, focusing in particular on those who inject stimulants as well as those experiencing economic hardship, including individuals without homes.

To read the aidsmap article, click here.

To read the conference abstract, click here.