HIV: Washington healthcare providers urged to take action to help prevent HIV

Posted May 15, 2019. Past health advisories and alerts are archived for historical purposes and are not maintained or updated.

An increase in newly diagnosed HIV infections among people who inject drugs in King County, WA has prompted the Washington State Department of Health to issue a health advisory requesting that health care providers throughout Washington State increase their HIV testing among patients reporting current or recent injection drug use. Early detection and treatment of acute HIV infection is essential to safeguard the health of people living with HIV and reduce forward transmission. 

To date, the Washington State Department of Health has not observed a similar increase in HIV diagnoses among people who inject drugs in other regions of the state, however, there is concern that areas outside of King County are vulnerable to increases in HIV transmission among people who inject drugs. 

Recommendations:

  1. Assess and evaluate patients for HIV risk factors:
    • Elicit behavioral risk history including injection drug use, transactional sex, methamphetamine use, unstable housing/homelessness. Click this link for information on taking a comprehensive sexual history, which can be adapted for taking a drug use history.
    • Asymptomatic people who inject drugs should be tested for HIV, hepatitis C, and syphilis at least annually. Follow current national recommendations for routine HIV and hepatitis C testing. For information on increases in syphilis among people who inject drugs click here.
    • All people who inject drugs who present with symptoms consistent with acute HIV infection (e.g., fever, fatigue, myalgia, headache, pharyngitis, adenopathy) should be tested for HIV.
  2. Promptly report new cases of HIV infection to Spokane Regional Health District:
    • Provide as much risk history, clinical, and demographic data (including complete contact information for the patient) as you can obtain. Use this reporting form.
  3. Link all people recently diagnosed or living with untreated HIV to care for full evaluation, follow-up, and prompt initiation of antiretroviral therapy.
    • Focused efforts should be made to optimize treatment adherence and retain patients in care. The Spokane Regional Health District has programs to help people at risk for HIV and people living with HIV access medication, medical care, and support to improve their health.
    • Offer HIV pre-exposure prophylaxis (PrEP) to people who inject drugs and/or engage in transactional sex.
  4. If needed, request support for HIV partner notification and linkage to support services and insurance.
  5. Provide people who inject drugs with information about where to access sterile injection equipment.
  6. Provide information about substance use treatment programs, including information about availability of medication assisted therapies, to patients interested in reducing or ceasing drug use.
  7. Educate people who inject drugs about the availability of naloxone to prevent overdose death.
    • Opioid overdose death is preventable with naloxone. Visit stopoverdose.org for more information about naloxone, including where people can access it.

Services available from Spokane Regional Health District: