HIV Infection Linked to Injection Use of Oxymorphone in Indiana, 2014-2015
dc.contributor.author | Peters, Philip J. | |
dc.contributor.author | Pontones, Pamela | |
dc.contributor.author | Hoover, Karen W. | |
dc.contributor.author | Patel, Monita R. | |
dc.contributor.author | Galang, Romeo R. | |
dc.contributor.author | Shields, Jessica | |
dc.contributor.author | Blosser, Sara J. | |
dc.contributor.author | Spiller, Michael W. | |
dc.contributor.author | Combs, Brittany | |
dc.contributor.author | Switzer, William M. | |
dc.contributor.author | Conrad, Caitlin | |
dc.contributor.author | Gentry, Jessica | |
dc.contributor.author | Khudyakov, Yury | |
dc.contributor.author | Waterhouse, Dorothy | |
dc.contributor.author | Owen, S. Michele | |
dc.contributor.author | Chapman, Erika | |
dc.contributor.author | Roseberry, Jeremy C. | |
dc.contributor.author | McCants, Veronica | |
dc.contributor.author | Weidle, Paul J. | |
dc.contributor.author | Broz, Dita | |
dc.contributor.author | Samandari, Taraz | |
dc.contributor.author | Mermin, Jonathan | |
dc.contributor.author | Walthall, Jennifer | |
dc.contributor.author | Brooks, John T. | |
dc.contributor.author | Duwve, Joan M. | |
dc.contributor.author | Indiana HIV Outbreak Investigation Team | |
dc.contributor.department | Department of Health Policy and Management, Richard M. Fairbanks School of Public Health | en_US |
dc.date.accessioned | 2017-04-12T19:33:49Z | |
dc.date.available | 2017-04-12T19:33:49Z | |
dc.date.issued | 2016-07-21 | |
dc.description.abstract | BACKGROUND: In January 2015, a total of 11 new diagnoses of human immunodeficiency virus (HIV) infection were reported in a small community in Indiana. We investigated the extent and cause of the outbreak and implemented control measures. METHODS: We identified an outbreak-related case as laboratory-confirmed HIV infection newly diagnosed after October 1, 2014, in a person who either resided in Scott County, Indiana, or was named by another case patient as a syringe-sharing or sexual partner. HIV polymerase (pol) sequences from case patients were phylogenetically analyzed, and potential risk factors associated with HIV infection were ascertained. RESULTS: From November 18, 2014, to November 1, 2015, HIV infection was diagnosed in 181 case patients. Most of these patients (87.8%) reported having injected the extended-release formulation of the prescription opioid oxymorphone, and 92.3% were coinfected with hepatitis C virus. Among 159 case patients who had an HIV type 1 pol gene sequence, 157 (98.7%) had sequences that were highly related, as determined by phylogenetic analyses. Contact tracing investigations led to the identification of 536 persons who were named as contacts of case patients; 468 of these contacts (87.3%) were located, assessed for risk, tested for HIV, and, if infected, linked to care. The number of times a contact was named as a syringe-sharing partner by a case patient was significantly associated with the risk of HIV infection (adjusted risk ratio for each time named, 1.9; P<0.001). In response to this outbreak, a public health emergency was declared on March 26, 2015, and a syringe-service program in Indiana was established for the first time. CONCLUSIONS: Injection-drug use of extended-release oxymorphone within a network of persons who inject drugs in Indiana led to the introduction and rapid transmission of HIV. (Funded by the state government of Indiana and others.). | en_US |
dc.eprint.version | Final published version | en_US |
dc.identifier.citation | Peters, P. J., Pontones, P., Hoover, K. W., Patel, M. R., Galang, R. R., Shields, J., ... & Conrad, C. (2016). HIV infection linked to injection use of oxymorphone in Indiana, 2014–2015. New England Journal of Medicine, 375(3), 229-239. http://doi.org/10.1056/NEJMoa1515195 | en_US |
dc.identifier.issn | 1533-4406 | en_US |
dc.identifier.uri | https://hdl.handle.net/1805/12238 | |
dc.language.iso | en_US | en_US |
dc.publisher | New England Journal of Medicine | en_US |
dc.relation.isversionof | 10.1056/NEJMoa1515195 | en_US |
dc.relation.journal | The New England Journal of Medicine | en_US |
dc.rights | Publisher Policy | en_US |
dc.source | Publisher | en_US |
dc.subject | Disease Outbreaks | en_US |
dc.subject | HIV Infections | en_US |
dc.subject | epidemiology | en_US |
dc.subject | HIV-1 | en_US |
dc.subject | genetics | en_US |
dc.subject | Oxymorphone | en_US |
dc.subject | administration & dosage | en_US |
dc.subject | Substance Abuse, Intravenous | en_US |
dc.subject | complications | en_US |
dc.title | HIV Infection Linked to Injection Use of Oxymorphone in Indiana, 2014-2015 | en_US |
dc.type | Article | en_US |
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