[Politico] A cluster of HIV cases in a rural West Virginia county represents what public health officials have long feared amid the nationwide opioid epidemic.Cabell County has reported 74 cases since January 2018, primarily among drug users sharing contaminated needles. The recent surge in infections represents the convergence of two major health epidemics, HIV and opioids, the Trump administration has pledged to fight.
The fact that the uptick is happening in a rural county with an unusually robust public health system ‐ which already does much of what the Trump administration wants to replicate nationwide as it seeks to eradicate HIV transmission within a decade ‐ may be fortuitous for officials trying to prevent a broader outbreak. But the fact that the cases have occurred despite the county's surveillance and prevention is also worrisome.
"The ground is fertile," said Judith Feinberg, a professor of behavioral medicine and infectious diseases at West Virginia University. "This is the nightmare everyone is worried about."
The latest swell in HIV cases appears to be among the largest since an outbreak in Indiana’s Scott County four years ago, when more than 200 people were infected largely through injecting a powerful prescription opioid using dirty needles. Vice President Mike Pence, then governor of Indiana, was widely criticized for dragging his feet before allowing the distribution of sterile needles to prevent the spread of HIV and hepatitis C among intravenous drug users. Surgeon General Jerome Adams, who at the time was Pence’s top health aide, was credited with bringing the outbreak under control.