Public Health

New article via John Hopkins Medicine

“People infected with the hepatitis C virus are at risk for liver damage, but the results of a new Johns Hopkins study now show the infection may also spell heart trouble…We have strong reason to believe that infection with hepatitis C fuels cardiovascular disease, independent of HIV and sets the stage for subsequent cardiovascular trouble,” says study principal investigator Eric Seaberg, Ph.D., assistant professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “We believe our findings are relevant to anyone infected with hepatitis C regardless of HIV status.”

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http://www.nejm.org/doi/full/10.1056/NEJMp1507252#t=article

‘On March 26, 2015, Indiana Governor Mike Pence issued an executive order declaring a public health emergency in several counties across Indiana due to a rapidly escalating outbreak of human immunodeficiency virus (HIV).

In just a few short years, there has been a large increase in the number of young people abusing opiates. This increase in injection-drug use and the high rate of HIV and HCV transmission through drug injection means that needles are in short supply, and injection-drug users are turning to sharing needles.

Indiana is one of 25 states in the U.S. where it’s illegal to purchase syringes without a prescription and where state law does not authorize needle-exchange programs. Thus why Governor Pence declared a state of emergency, which enabled him to temporarily suspend the law and introduce a temporary needle-exchange program.

However, this needle-exchange program deters many people from participating because it requires that injection-drug users register with their initials and date of birth and unregistered injection-drug users are subject to prosecution for carrying syringes. (Using needles for non-medical purposes is a felony punishable by up to 3 years in prison.)

In order to prevent further HIV outbreaks among substance users, aggressive implementation of evidence-based practices for HIV prevention must be put in place. Permanently lifting the ban on using federal funds to support needle-exchange programs will be a critical component of HIV prevention, since these programs reduce HIV incidence. The federal funding ban limits these programs scalability and quality of services, including their ability to provide on-site HIV and HCV testing and referrals for drug treatment.’

Synopsis of Threading the Needle — How to Stop the HIV Outbreak in Rural Indiana by Steffanie A. Strathdee, Ph.D., and Chris Beyrer, M.D., M.P.H.