On the Rise: City officials warn of spike in AIDS cases among IV drug users

There are no shortage of public health emergencies attributed to the opiate epidemic, and now the City is reporting that there has been a spike of HIV/AIDs infections in the Mass/Cass area among those using drugs intravenously.
It has been a shocking revelation and a setback to extremely successful efforts to rid the using community of HIV infections over the past decade, but Health Chief Marty Martinez said this week there have been 12 new infections in only a short period of time, sending up a major red flag.
That is contrasted with virtually no infections, or just a few, over the last several years. That elimination of new infections had been a key victory claimed by the City’s AHOPE needle exchange program, as its advocates have said providing clean needles and supplies has been the difference- maker.
Now, though, something has changed.
“Within the last several months we have seen 12 new HIV infections in the neighborhood and that is a tremendous amount of new infections,” said Martinez at the Blackstone/Franklin Neighborhood Association meeting. “In that short period of time, we’ve seen 12 folks test positive for HIV. All of them are identified as suffering from substance use disorder and using drugs intravenously. So, it is really, really important we have clean needles for folks and we’re giving folks clean needles so they’re not spreading infections or disease.”
What is believed to be happening is that the full grips of Fentanyl is hitting the community that uses drugs regularly in the Mass/Cass area. With heroin, users often would inject two to five times a day. However, Fentanyl is said to be a much more intense, but shorter high. That causes users to crave the drug even more, and to inject upwards of 20 times a day. Though users in the Mass/Cass area have access to clean needles at AHOPE, there is no way for them to access 20 clean needles a day.
That has driven many to use dirty needles, or share needles with others. Already, on the streets, the City recovery workers have started an informational campaign to ‘Clean Your Works,’ which references the practice of sterilizing needles used more than once.
At the Mass/Cass 2.0 Task Force, the matter has come up as well.
Task Force member Mike Nelson of Worcester Square, and David Stone, of Blackstone/Franklin, appeared at the Worcester Square Area Neighborhood Association (WSANA) on Tuesday and said it has come up in their first two meetings.
Nelson said they heard a presentation by Dr. Alfred DeMaria, an infectious disease medical director and state epidemiologist at the Department of Public Health (DPH).
Nelson said they were told there have been 12 cases reported in the last four months, and Dr. DeMaria said it is patterning off of an HIV outbreak that occurred in Lawrence and Lowell in 2018. That was an outbreak that he studied on the ground, noting in the region there they had 23 cases in 2016 and 52 in 2017. The state and DeMaria ended up requesting the help of the U.S. Centers for Disease Control (CDC) in that outbreak.
Here, most of the new cases have been associated with those already infected with other ailments, like Hepatitis C.
“It’s almost always paired with Hepatitis C,” Nelson said. “That is telling us we’re getting back into these microspheres of infectious diseases being spread through shared drug apparatus. It’s happening because of opiates and Fentanyl and people using more often.”
Stone said the City is trying to figure out a way to incentivize returning needles to AHOPE and other places, but they cannot use cash. At this point, they are looking at low-value gift cards and such.
Nelson said one thing they were told that is being done is recovery workers have identified users in the area – mostly homeless – who are particularly at risk for being infected. Those users are sought out and administered super doses of anti-biotics every day to prepare their body to fight off such infections. However, most of those people are in encampments, and when the encampments are broken up as part of Mass/Cass 2.0, it becomes harder to find those individuals.
“That’s helpful and it’s expensive, but the problem is you have to take it every day,” said Nelson. “It’s not a population that carries around a pill organizer. When you break up the encampments, you then often cannot find that person to give them the prep pill daily.”
Martinez said the outbreak has motivated them to spread out the locations for needle exchange, making quicker efforts at the decentralization of services in the Mass/Cass 2.0 plan. He said they have had conversations, but they need to do more legwork.
“We have started to do that work,” he said. “We haven’t made a ton of progress on it aside from multiple conversations. A series of those conversations have been creating more access to syringe exchange in other neighborhoods outside of (the South End).
“This is why we’re still looking for syringe exchange programs in other neighborhoods,” he continued. “We’ve had conversations with community health centers, some current providers, but the state has to license those and help pay for those. So, we’ve started those conversations and are close, but as you can imagine, what we have not done is go to the neighborhood and tell them we are bringing syringe exchange there.”

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