Officials Warn of More HIV Transmissions Among Homeless Drug Users

A group of eight recently homeless and heterosexual injection drug users in North King County were diagnosed with HIV by county health officials over the past year, prompting concerns that HIV transmissions among that population may be on the rise.

In total, 19 heterosexual individuals have been diagnosed with HIV in King County over the past year, up from seven last year. On average, ten heterosexual individuals are diagnosed with HIV every year, according to health officials.

What makes the spike especially significant, according to Jeff Duchin, health officer at King County Public Health, is that it’s occurring among a demographic that hasn’t traditionally experienced high rates of HIV infection: heterosexual injection drug users. Historically, gay and bisexual men have been most at risk of contracting HIV, both in King County and across the state. Similarly, local gay and bisexual injection drug users—specifically those that use methamphetamine, a stimulant—experienced higher HIV infection rates. However, given that injection drug users across the county are increasingly using both opioids (such as heroin) and methamphetamine, health officials are concerned that more heterosexual drug users may be contracting HIV.

“If HIV begins to spread in a new population of persons who inject drugs who don’t have other risk factors for HIV, there can be a large outbreak, potentially,” Duchin said at a Aug. 30 press conference. “All of our recently identified cases have used both opioids and methamphetamine.”

Additionally, many injection drug users in the county are homeless, Duchin said, potentially increasing the risk of needle-sharing. Of the eight individuals in North King County recently diagnosed with HIV who were heterosexual and recently homeless, some of them traded sex for drugs or money, and health officials have identified transmission links between four of them, Duchin said.

The eight individuals—which Duchin described as a “cluster”—were identified through the county’s HIV monitoring program. Medical providers and laboratories are required to notify health officials when a patient tests positive for HIV, who then try to get the individuals connected to services and treatment. While some of the individuals who contracted HIV this year were identified through this system, others were identified only after additional investigation by public authorities, adding to the concern that there may be more unreported cases among a population that doesn’t get frequent access to medical services or may struggle to stay on HIV treatment drugs. (HIV is treatable with drugs dubbed antiretrovirals, which, if taken on a regular regimen, can significantly reduce a patient’s viral load.)

“Homelessness and injection drug use go hand-in-hand in our community and homeless people have poor access to medical care,” Duchin said. “If they have HIV infections sometimes it’s more difficult for them to comply with their treatment and therefore they may have a higher viral load and be more likely to transmit.”

Duchin said that while there is cause for concern, more data is needed to draw and substantive conclusions. “We need to do more testing and try and find out if this is the tip of the iceberg or if this is a small, limited transmission event that we’ve discovered,” he said.

“If this problem is more extensive than we know or it continues to grow, it could present a very large challenge to our HIV control program and to our community.”

He said that public health officials are increasing outreach among homeless or recently homeless injection drug users to test them, get them connected to treatment, and distribute sterile syringes.

More in News & Comment

Washington State Capitol Building. Photo by Emma Epperly/WNPA Olympia News Bureau
Legislation targets rape kit backlog

WA has about 10,000 untested kits; new law would reduce testing time to 45 days

Two Issaquah High School students are under investigation after a racially insensitive photo surfaced over the weekend. Courtesy photo
Racially insensitive sign sparks investigation in Issaquah

High school students under investigation after Tolo photo goes viral.

Snohomish family detained by Border Patrol while on vacation

Little information has been provided since they were arrested Thursday near Tucson, Arizona.

Yaaah! Hipster Gregr of ‘Nerd Talk’ escapes city life

The morning host of radio station 107.7 The End has traded the Seattle vibe for Snohomish living.

Price of renovated Seattle arena soars to over $900 million

But Tod Leiweke says the privately financed venue will be “one of the finest buildings in the country.”

Walkers rest amid the trees at Island Center Forest on Vashon Island, which is part of King County. Many trees around Western Washington are struggling, including Western hemlock on Vashon, likely from drought stress. Photo by Susie Fitzhugh
King County forests are facing new challenges

Hot, dry summers are stressing native tree species in Western Washington.

Yoga for horses exists, and it’s exactly what you think it is

A Snohomish-area veterinarian teaches equine stretches important to health and performance.

Heading north after leaving the Mountlake Terrace Transit Center, the light rail track will cross to the west side of I-5. Trees on both sides of the highway here will be heavily impacted by the buildout. (Lizz Giordano / The Herald)
To make room for light rail, 5,300 trees will fall along I-5

Sound Transit expects to start clearing in late April and eventually replant more than 20,000 trees.

Jim Pitts stands on walkway overlooking filtration chambers at the King County South Treatment Plant in Renton. Aaron Kunkler/staff photo
Human waste: Unlikely climate change hero?

King County treatment plant joins effort to counteract effects of carbon dioxide.

Most Read