Pandemic, drug use fuel HIV spread

The Centers for Disease Control and Prevention has another troubling outbreak on its hands. On April 5, Sen. Joe Manchin, D-W.Va., asked the agency to review a recent surge in HIV cases in his state. Intravenous drug use in two counties—Kanawha, which includes the capital city of Charleston, and Cabell—has driven the increase.

Dr. Sherri Young, health officer of the Kanawha-Charleston Health Department, said the coronavirus pandemic restricted the county’s usual methods of combating HIV, including health fairs and widespread testing. But many also suspect that canceling a Kanawha County needle exchange program in 2018 is partly to blame.

In 2018, Kanawha County had two HIV cases from intravenous drug use. In 2019, that number was 15, and then in 2020, it grew to 35. For comparison, New York City, with a population of more than 8 million, had 36 IV drug use cases of HIV in 2019. Kanawha County has about 178,000 residents

Dr. Demetre Daskalakis, CDC chief of HIV prevention, called the outbreak in Kanawha County “the most concerning in the United States.”

In March, Kanawha County announced more HIV testing, and the Department of Health and Human Services promised more than $2.3 million to support the state’s efforts. On April 15, West Virginia Gov. Jim Justice, a Republican, signed a law to regulate programs that provide clean needles to drug users. Those programs aim to prevent the spread of infections from shared needles.

Kanawha County shut down its needle exchange program in 2018 after receiving complaints about used needles littering public property. A few smaller groups still provide needle exchanges, but the new law places limits on providers that could force them to close. It requires them to be licensed and offer other health services, including overdose prevention education and referrals to drug treatment programs. It would also require drug users to show ID before getting a clean needle.

Supporters say the law will result in connecting users with health services and preventing the irresponsible distribution that resulted in abandoned needles in public spaces. Opponents say it will mean drug users continue to suffer.

“We are really going to regret this. There are going to be people that are going to die,” said Democratic state Del. Barbara Fleischauer. “A good needle exchange program opens the door for recovery. And we are going to be shutting that door.”

Needle exchange programs are one example of the controversial “harm reduction” philosophy of helping those addicted to drugs. The same philosophy is behind the push for sobering centers, where publicly intoxicated people can sober up instead of going to jail, and safe injection sites, where drug users can enjoy supervised highs with medical personnel ready to assist with overdoses. Such programs can preserve life and protect people from the consequences that often accompany drug or alcohol addictions, but they can also enable destructive habits and remove opportunities for accountability and change.

Addiction counselor Mark Shaw points out that providing clean needles might not even be preserving life, as proponents argue: “The next use of a drug, especially heroin mixed with fentanyl, could be the addict’s last use. It is dangerous to encourage continued drug use. Addicts don’t know what is being mixed into the drugs they buy.”

He said the logic of providing clean needles could also be applied to giving users purer and safer drugs to continue their addiction.

“In the fight against addiction, we should go after the heart,” Shaw said. “God has answers for every person’s heart, and that includes those struggling with addiction.”