The Indiana University School of Medicine and the BC Centre for Excellence in HIV/AIDS have joined forces to respond to a highly concentrated HIV epidemic driven by the injection of prescription opioids in Austin, Indiana.
Austin, in Scott County, has an estimated population of 4,200 with approximately 10 percent of the population injecting opioids on a daily basis. Since early last year, 184 new HIV infections have been identified.
The joint effort will provide an opportunity to leverage successes achieved by the BC Centre for Excellence in HIV/AIDS in British Columbia by applying its effective HIV Treatment as Prevention® model to a rural setting in the United States. The National Institute on Drug Abuse, an agency of the National Institutes of Health, is supporting the effort with a two-year, $200,000 grant, with additional funding coming from the School of Medicine's Department of Medicine.
"We are embarking on this project with a sense of optimism and hope, bolstered by the NIH support, the accomplishments of the BC Centre for Excellence in HIV/AIDS and our expertise in delivering HIV care in resource-constrained settings," said Kara Wools-Kaloustian, M.D., associate professor of medicine and director of the Division of Infectious Diseases at the IU School of Medicine.
"We have a chance to reverse the course of this HIV epidemic by implementing fast-acting and effective evidence-based strategies. Using innovations in science and technology, as well as targeted and compassionate approaches to reach those affected by this outbreak, this has the potential to decrease HIV transmission and help save lives within the state of Indiana," she said.
Through this effort, researchers will implement strategies and technologies previously shown to be successful in British Columbia and will investigate, track, and curb the spread of HIV in Indiana.
The international team aims to identify factors that affect whether individuals seek and continue with HIV treatment. The team will apply mapping technology to track and assess risk factors for HIV transmission, and laboratory-based research will provide a precise, but anonymous, view into clustering of HIV transmission events. Finally, researchers will investigate how to effectively counter the public health harms of injection drug use through the expansion of harm reduction services and other programs at both the patient and system-level.
"Treatment as Prevention® has been implemented across diverse international jurisdictions from China to Panama to major cities within the United States," said Julio Montaner, M.D., director of the BC Centre for Excellence in HIV/AIDS who will be co-leading the research.
"The situation in Indiana marks a critical need for implementing best practices in harm reduction and HIV prevention. Treatment as Prevention® is a model for opening up access to early HIV treatment and care, for reducing stigma, and for targeted disease elimination," Dr. Montaner said. "Providing sustained, consistent treatment and care ensures that an individual's viral load decreases, dramatically reducing the likelihood of disease progression and secondarily stopping HIV transmission."
"This is an excellent opportunity to expand the successful scientific model implemented within British Columbia and create public health programs that can save lives, applying lessons learned to a growing prescription opioid addiction and drug use problem," said Jacques Normand, Ph.D., director of AIDS Research at the National Institute on Drug Abuse. The BC Centre for Excellence in HIV/AIDS will work to complement efforts by the U.S. Department of Health and Human Services and other agencies to improve HIV prevention, diagnosis and care for the residents of Scott County.