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x7x_x7x
x7x, my problem child.




Registered: 05/05/07
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Community Outbreak of HIV Infection Linked to Injection Drug Use of Oxymorphone — Indiana, 2015
#21725624 - 05/26/15 05:13 PM (8 years, 8 months ago) |
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Caitlin Conrad; Heather M. Bradley; Dita Broz; Swamy Buddha; Erika L. Chapman; Romeo R. Galang; Daniel Hillman; John Hon; Karen W. Hoover; Monita R. Patel; Andrea Perez; Philip J. Peters; Pam Pontones; Jeremy C. Roseberry; Michelle Sandoval; Jessica Shields; Jennifer Walthall; Dorothy Waterhouse; Paul J. Weidle; Hsiu Wu; Joan M. Duwve Disclosures Morbidity and Mortality Weekly Report. 2015;64(16):443-444.
On January 23, 2015, the Indiana State Department of Health (ISDH) began an ongoing investigation of an outbreak of human immunodeficiency virus (HIV) infection, after Indiana disease intervention specialists reported 11 confirmed HIV cases traced to a rural county in southeastern Indiana. Historically, fewer than five cases of HIV infection have been reported annually in this county. The majority of cases were in residents of the same community and were linked to syringe-sharing partners injecting the prescription opioid oxymorphone (a powerful oral semi-synthetic opioid analgesic). As of April 21, ISDH had diagnosed HIV infection in 135 persons (129 with confirmed HIV infection and six with preliminarily positive results from rapid HIV testing that were pending confirmatory testing) in a community of 4,200 persons.[1]
The age range of the 135 patients is 18–57 years (mean = 35 years; median = 32 years); 74 (54.8%) are male. A small number of pregnant women were diagnosed with HIV infection and started on antiretroviral therapy during pregnancy. As of April 21, no infants had tested positive for HIV. Of the 135 persons with diagnosed HIV infection, 108 (80.0%) have reported injection drug use (IDU), four (3.0%) have reported no IDU, and 23 (17.0%) have not been interviewed to determine IDU status. Among the 108 who have reported IDU, all reported dissolving and injecting tablets of oxymorphone as their drug of choice. Some reported injecting other drugs, including methamphetamine and heroin. Ten (7.4%) female patients have been identified as commercial sex workers. Coinfection with hepatitis C virus has been diagnosed in 114 (84.4%) patients.
The patients were interviewed about syringe-sharing and sex partners, as well as any social contacts who also might have engaged in high risk behaviors. Those interviewed reported an average of nine syringe-sharing partners, sex partners, or other social contacts who might be at risk for HIV infection. Of the 373 contacts named as of April 21, a total of 247 (66.2%) had been located, 230 (61.7%) were tested, and 17 (4.6%) either declined testing or were not able to be tested. Of the 230 contacts who were tested, test results for 109 (47.4%) were HIV positive, and 121 (52.6%) were HIV negative. Of the 128 contacts who have not yet been located, 74 (57.8%) have been identified as syringe-sharing or sex partners, and 54 (42.2%) are social contacts regarded as at high risk for HIV infection.
Injection drug use in this community is a multi-generational activity, with as many as three generations of a family and multiple community members injecting together. IDU practices include crushing and cooking extended-release oxymorphone, most frequently 40 mg tablets not designed to resist crushing or dissolving. Syringes and drug preparation equipment are frequently shared (e.g., the drug is dissolved in nonsterile water and drawn up into an insulin syringe that is usually shared with others). The reported daily numbers of injections ranged from four to 15, with the reported number of injection partners ranging from one to six per injection event.
Like many other rural counties in the United States, the county has substantial unemployment (8.9%), a high proportion of adults who have not completed high school (21.3%), a substantial proportion of the population living in poverty (19%), and limited access to health care.[1] This county consistently ranks among the lowest in the state for health indicators and life expectancy.[2]
ISDH worked with the only health care provider in the immediate community, local health officials, law enforcement, community partners, regional health care providers and CDC to launch a comprehensive response to this outbreak. A public health emergency was declared on March 26 by executive order.[3] The response has included a public education campaign, establishment of an incident command center and a community outreach center, short-term authorization of syringe exchange, and support for comprehensive medical care including HIV and hepatitis C virus care and treatment as well as substance abuse counseling and treatment. State and local health departments and academic partners, with the assistance of CDC, are working to implement and improve the community outreach programs supported by the executive order and to interrupt IDU-related HIV and hepatitis C virus transmission. Contact tracing by state and CDC disease intervention specialists continues to identify those potentially exposed.
This HIV outbreak involves a rural population, historically at low risk for HIV, in which HIV infection spread rapidly within a large network of persons who injected prescription opioids. The Indiana public health response includes implementing programs to contain the spread of HIV and hepatitis C virus, curb injection drug use, and concurrently build social resilience in the community. The outbreak highlights the vulnerability of many rural, resource-poor populations to drug use, misuse, and addiction, in the context of a high prevalence of unaddressed comorbid conditions.[4] The outbreak also demonstrates the importance of timely HIV and Hepatitis C surveillance activities and rapid response to interrupt disease transmission. Finally, the outbreak points to the need for expanded mental health and substance use treatment programs in medically underserved rural areas.[5]
References
US Census Bureau. State and county quickfacts: Indiana. Available at http://quickfacts.census.gov/qfd/states/18000.html.
University of Wisconsin Population Health Institute. County health rankings and roadmaps. Available at http://www.countyhealthrankings.org/.
State of Indiana. Executive order 15–05. Available at http://www.in.gov/gov/2384.htm.
Substance Abuse and Mental Health Services Administration. Results from the 2013 national survey on drug use and health: summary of national findings. Rockville, MD: US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration; 2014. Available at http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf.
Lenardson JD, Gale JA. Research and policy brief. Distribution of substance abuse treatment facilities across the rural-urban continuum. Portland, ME: Maine Rural Health Research Center; 2008. Available at http://muskie.usm.maine.edu/Publications/rural/pb35bSubstAbuseTreatmentFacilities.pdf.
http://www.medscape.com/viewarticle/844101?nlid=81694_724&src=wnl_edit_medp_aids&uac=38384PG&spon=1
-------------------- cultivando en la miseria SuctoSpore® Pictorial Tek
 x7x_x7x@shroomery.org carl_jung_in_lsd@yahoo.com koh samui and oak ridge are my favourite strains
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Detached
You know where...


Registered: 02/27/15
Posts: 2,942
Last seen: 10 months, 15 days
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Re: Community Outbreak of HIV Infection Linked to Injection Drug Use of Oxymorphone — Indiana, 2015 [Re: x7x_x7x]
#21726024 - 05/26/15 06:53 PM (8 years, 8 months ago) |
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That is interesting. Terrible nonetheless. Hep C is nasty enough but throwing some HIV in there makes for a bad day.
It is sort of a paradox - people share needles all the time but you wouldn't hear about this in a big city where tracking these statistics is much more difficult, in addition to a larger group of IV users that are less likely to run into each other.
I wonder if a rural needle exchange in the area would have prevented the size of this "outbreak."
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Mental Taco



Registered: 07/02/14
Posts: 2,290
Loc: Hell
Last seen: 6 years, 8 months
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Re: Community Outbreak of HIV Infection Linked to Injection Drug Use of Oxymorphone — Indiana, 2015 [Re: Detached]
#21726161 - 05/26/15 07:29 PM (8 years, 8 months ago) |
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Pretty unfortunate.
I wonder if using proper sterilization techniques between users could kill the virus for example good rinsing and heating of the needle between users.
-------------------- Did you not know that the royal hunting grounds are always forbidden?
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durian_2008
Cornucopian Eating an Elephant



Registered: 04/02/08
Posts: 16,693
Loc: Raccoon City
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Re: Community Outbreak of HIV Infection Linked to Injection Drug Use of Oxymorphone — Indiana, 2015 [Re: Mental Taco]
#21726812 - 05/26/15 10:12 PM (8 years, 8 months ago) |
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These are nice things to say, but you're assuming that they're concerned about health.
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funkyfish77
out



Registered: 06/10/10
Posts: 429
Loc:
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Re: Community Outbreak of HIV Infection Linked to Injection Drug Use of Oxymorphone — Indiana, 2015 [Re: durian_2008]
#21727589 - 05/27/15 06:57 AM (8 years, 8 months ago) |
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I don't live very far from were all that is going on. It's bad to say but most of those people don't care . The state park out there is littered with syringes . It's a shame to see people that wrapped up in drugs they stop caring about themselves and there family. Most people aren't going to the needle exchanges cause u have to give them your information . They are telling everyone around here not to have unprotected sex or share needles and if you have to go get tested . That shit is crazy . I'm glad I'm happily married.
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Cognitive_Shift
CS actual




Registered: 12/11/07
Posts: 29,591
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Re: Community Outbreak of HIV Infection Linked to Injection Drug Use of Oxymorphone — Indiana, 2015 [Re: funkyfish77]
#21728288 - 05/27/15 11:08 AM (8 years, 8 months ago) |
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Banging opana in indiana? I would have thought the mexicans had that market too:stroke beard:
-------------------- L'enfer est plein de bonnes volontés et désirs
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funkyfish77
out



Registered: 06/10/10
Posts: 429
Loc:
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Re: Community Outbreak of HIV Infection Linked to Injection Drug Use of Oxymorphone — Indiana, 2015 [Re: Cognitive_Shift]
#21728415 - 05/27/15 11:45 AM (8 years, 8 months ago) |
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I think it's heroin personally but I don't use . It's not just the rural areas that have a problem. I'm in the big city just to the south and it's pretty bad here too. I've had several friends get bad off of it .
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