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Appalachia Health News tells the story of our health challenges and how we overcome them throughout the region. 

CDC Brings Forces to Kanawha County During HIV Crisis

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The Kanawha Charleston Health Department in downtown Charleston.

Kanawha County has the most alarming HIV outbreak in the nation, according to the Centers for Disease Control and Prevention. But Tuesday, a small team from the CDC arrived in the capitol city to figure out what more could be done to stomp out this growing epidemic.

In February, the CDC offered to help. With a push from Charleston Mayor Amy Goodwin, the state requested an “Epi-Aid” -- an investigation followed by rapid, short-term assistance.

In April, the CDC sent two specialists to Charleston for a three-month term. Now, the CDC is sending reinforcements -- a team of five to nine people will work in Charleston for four weeks, along with a host of experts working remotely.

“This will enhance our efforts, we welcome the Epi-Aid, and we are very thankful that the state helped us in getting that from the CDC,” said Dr. Sherri Young, director of the Kanawha-Charleston Health Department. She made her request to the state after hearing from the mayor.

Kanawha County is not the first to receive an Epi-Aid. In 2019, when Cabell County, West Virginia, documented 69 new cases of HIV, the CDC quickly came to help.

“There were a lot of people on the ground here,” said Dr. Michael Kilkenny, the CEO and health officer of the Cabell-Huntington Health Department, who says the CDC offered critical assistance to his department's efforts.

Nearly all of the new HIV cases in Cabell County were caused by intravenous drug use and needle sharing. The county had a syringe service program already, but the CDC said it needed to be bigger, and the county health department and local officials took their advice.

“Everybody just pulled together to offer all of the resources or all of the services that were going to help,” Kilkenny said.

Kilkenny was amazed by how CDC specialists could gain the trust of IV drug users -- many of whom are homeless -- so quickly.

“They're not from around here, but they're so well-trained, that they could talk to anybody, probably anywhere in the world,” he said.

New cases dropped -- from 69 in 2019, to 40 in 2020, and less than 10 so far this year. Kilkenny knows it’s not over, but he says without the CDC, the outbreak might have never gotten under control.

Now, Charleston is facing a similar crisis. The county has identified 89 new HIV cases since 2019 -- 66 of those among IV drug users.

Dr. Christine Teague has worked with people who are HIV-positive for 25 years. In the past, she says her patients at the Charleston Area Medical Center’s Ryan White Foundation were relatively stable, with secure housing and some income. But things have changed.

Now, her patients are among the most vulnerable in society, struggling with addiction and homelessness.

“It's just basic survival and accessing drugs so that they won't go into withdrawal and become sick,” Teague said.

For people in such dire straits, preventing or treating HIV can be a low priority. And many of the folks who are turning up HIV positive don’t have mailing addresses, cell phones, or reliable transportation. Others are intimidated by visiting a big hospital complex, Teague said.

“We had one lady who didn't want to come into an appointment a couple weeks ago, because she hadn't been able to shower in two weeks, and she was embarrassed,” she said.

Teague said comprehensive HIV treatment is available, but it takes consistency to work.

Ultimately, Teague and others hope that the additional expertise will lead to more testing, treatment, contact-tracing and prevention specific to Charleston’s circumstances.

If the dwindling HIV numbers in Cabell County are any indication, Charleston may be on its way to finding some relief from the worst of the crisis.

“We all have to collaborate together,” Teague said. “The CDC will come in and study the situation and give us some guidance on how we can best move forward as a community.”


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