Vital Signs: HIV and Injection Drug Use

HIV diagnoses among PWID have decreased, but progress has been uneven.

The number of PWID getting HIV has been cut in half in the U.S.

• Annual HIV diagnoses among PWID decreased by 48% overall (2008–2014).
• Annual HIV diagnoses fell by about 50% among black and Hispanic/Latino PWID, both in urban and nonurban areas (2008–2014).
• Annual HIV diagnoses dropped by 28% among urban white PWID during 2008–2012, but did not decrease from 2012–2014. Trends among nonurban whites were similar.

There have been changes in who is starting to inject drugs.*

• In 2005, blacks and whites each made up 38% of new PWID (those who have been injecting for 5 years or less).
• In 2015, blacks made up 19% of new PWID and whites made up 54%.
• The percent of new PWID who are Hispanic/Latino stayed around the same at about 21%.

Some PWID are at higher risk for getting HIV from sharing syringes.*

• About 46% of new white PWID shared syringes, compared with 32% of Hispanics/Latinos and 28% of blacks.
• White PWID started injecting at younger ages than other races/ethnicities, and younger people were more likely to share syringes.
• Syringe sharing was low (13%) among PWID who got all their syringes from sterile sources like SSPs, but high (41%) among those who didn’t.

*In 22 cities with a high number of HIV cases

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The Federal government is

• Allowing certain state and local prevention programs to use their federal funds for SSPs (not to buy needles, syringes, and other injection equipment). For more information, visit https://www.hiv.gov/sites/default/files/hhs-ssp-guidance.pdf.
• Providing support and access to HIV, hepatitis, and substance use disorder prevention and treatment, including medication-assisted treatment and mental health services.
• Providing guidelines to healthcare providers for appropriate prescribing practices to reduce opioid abuse and overdoses.
• Monitoring national trends for HIV, hepatitis, and drug overdoses.

State and local health departments can

• Use data on HIV, hepatitis, substance use, and overdoses to determine where services are needed.
• Work with law enforcement and local leaders to expand access to SSPs, where permitted by law.
• Provide HIV and hepatitis testing and prevention services for PWID.
• Ensure treatment is available for overdoses, HIV, hepatitis, and substance use disorder, and inform first responders about available resources.

Healthcare providers can

• Screen patients for substance use disorder, including the misuse of prescription opioids. Provide or link PWID to medication-assisted treatment, and link them to mental health services, if needed. Use CDC opioid prescribing guidelines, http://bit.ly/1jTLLej
• Test PWID for HIV and hepatitis and treat them if they are infected. Vaccinate patients for hepatitis A and B, if appropriate.
• Prescribe sterile syringes to PWID, or refer them to SSPs or pharmacies that provide sterile syringes, where permitted by law.
• Provide or refer PWID to HIV risk reduction counseling. Consider prescribing pre-exposure prophylaxis (PrEP) for PWID at very high HIV risk.
• Prevent overdose deaths by providing naloxone or referring PWID to pharmacies or community-based programs that provide it, where permitted by law.

Lawmakers, judges, police and other criminal justice officials can

• Address legal and law enforcement barriers that prevent or discourage the use of SSPs and substance use disorder treatment, including use of medication-assisted treatment.
• Refer PWID to substance use disorder treatment and HIV and hepatitis prevention services.
• Support HIV and hepatitis testing and care and hepatitis vaccination in prisons and jails.

People who inject drugs can

• Get help to stop injecting drugs. SAMHSA.gov, or 1-800-662-HELP (4357).
• Use only new, sterile syringes, safely dispose of used syringes, and never share any equipment if injecting drugs. Contact the local health department or NASEN.org to find an SSP.
• Get tested for HIV and hepatitis C at least once a year. Get vaccinated for hepatitis A and B if not infected. People who have HIV or hepatitis should get medical care and take medicines as prescribed.

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