Opioid Epidemic Threatens to Undo HIV Progress

December 13, 2016

Needle sharing among opiate users poses a great risk of new HIV infections, and the lack of access to syringe services programs across the United States contributes to the problem, according to a November 2016 report by the Centers for Disease Prevention and Control.

Despite an increase in the use of syringe services programs (SSPs), which aim to reduce needle sharing by providing access to sterile syringes, the CDC report found one-third of injection drug users reported sharing a needle within the past year. Sharing needles may spread HIV, hepatitis B and hepatitis C viruses.

“Until now, the nation has made substantial progress in preventing HIV among people who inject drugs, but this success is threatened,” said Dr. Jonathan Mermin, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. He also commented on the effectiveness of SSPs and expressed that their expansion is vital for continued progress against HIV.

CDC Director Dr. Tom Frieden believes that opiates are detrimental to the decades of progress the United States has made in reducing HIV infections. Although AIDS diagnoses among people who inject drugs such as heroin have decreased 90 percent since 1993, the CDC report mentioned that 9 percent of HIV diagnoses in 2014 were among people who inject drugs. Only one in four injection drug users interviewed by the CDC reported getting all of their needles from a sterile source.

Expanded Access to Needle Exchange Programs Needed

Syringe services programs have a proven record of success, given the decrease in incidences of drug-related HIV infections among African-Americans and Latinos in 2015.

“It is encouraging to see prevention efforts paying off in African-American and Latino communities. We must now take concrete steps that build upon and accelerate that progress,” said Dr. Eugene McCray, director of the CDC’s Division of HIV/AIDS Prevention, in a press release. He also added that despite all these measures, injection drug users are still at a high risk of contracting HIV.

In an interview with The Huffington Post, Surgeon General Dr. Vivek Murthy commented on the effectiveness of safe syringe programs, highlighting how they successfully contributed to reducing the transmission of infectious diseases such as HIV and hepatitis C. He also explained that widespread implementation of needle exchange programs could help thwart potential HIV outbreaks.

“There are so many barriers to people using these programs. And the biggest one, I think, is access,” said Monica Ruiz, an associate research professor from The George Washington University, in an interview with Healthline.com. Indeed, syringe services programs are limited across the country. So far, only 15 states have obtained permission from Congress to request federal HIV prevention funds to set them up.

In a 2015 study published in the journal AIDS and Behavior, Ruiz studied the aftermath of the 2007 ban lift on use of municipal funds for SSPs in the District of Columbia. Ruiz and colleagues noted a 70 percent decrease in HIV diagnoses over two years, equivalent to the avoidance of 120 infections. This decrease saved millions of dollars that would otherwise have gone to HIV treatment.

Ruiz describes the program as a means to encourage drug-using communities to adopt a healthier lifestyle.

SSPs Work

Comprehensive SSPs not only provide drug-using communities with clean needles, but also refer people to appropriate testing and treatment services for HIV and hepatitis. Additionally, they treat drug overdoses and provide vaccines for hepatitis A and C.

In a press briefing, Mermin emphasized the efficiency of SSPs, highlighting their cost-saving benefits. He explained that each year SSPs could avert about 3,400 new HIV cases among injectable drug users and a lifetime treatment cost of $400,000 for each case. He added that it is important to work with the community and law enforcement to make sure that the programs are receiving adequate support to provide maximum benefits.

To address the concerns of critics of syringe services programs, Frieden pointed out that contrary to the myth that SSPs enable drug use, these programs have been preventing the spread of infections and helping people get treatment. He also mentioned that SSPs acted as a bridge between injection drug users and services that save lives and money.

Medical Disclaimer: DrugRehab.com aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

View Sources

• Schumaker, E. (2016, November 30). Opiates Are Threatening To Undo 3 Decades Of HIV Progress.
• Radcliffe, S. (2016, December 2). Why Needle Exchange Programs Are Important.
• CDC.gov. (2016, November 29). CDC Vital Signs: HIV and Injection Drug Use. Retrieved from https://www.cdc.gov/nchhstp/newsroom/2016/vs-hiv-injection-drug-press-release.html
• CDC.gov. (2016, November 30). Transcript for CDC Telebriefing: New Vital Signs Report – HIV & Injection Drug Use. Retrieved from http://www.cdc.gov/media/releases/2016/t1130-vital-signs-hiv-drug-use.html

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