Syringe exchange programs meant to slow HIV's alarming spread in West Virginia limited by political resistance

Photo by R. Konkathi, Unsplash

Despite federal recommendations and community efforts to stem HIV infections among opioid or methamphetamine users in central Appalachia, the disease continues to spread. Harm-reduction advocates and medical providers cite resistance to syringe exchange programs as the primary obstacle, reports Taylor Sisk of KFF Health News. "The situation likely hasn’t improved, in part because of politicians who contend that such programs encourage illegal drug use."

In 2021, West Virginia's HIV outbreak was particularly concerning to officials from the Centers for Disease Control and Prevention. Sisk writes, "The CDC’s HIV intervention chief called it 'the most concerning HIV outbreak in the United States and warned that the number of reported diagnoses could be just 'the tip of the iceberg.'" 

Rural areas without substance disorder treatment or disease education present a ripe breeding ground where HIV can spread undetected. Ryan White HIV/AIDS Program Director Christine Teague "is concerned for West Virginia’s rural counties, most of which don’t have a syringe service program," Sisk adds. "Tasha Withrow, a harm reduction advocate in rural Putnam County, said her sense is that HIV numbers aren’t alarmingly high there but said that with little testing and heightened stigma in a rural community, it’s difficult to know."

Robin Pollini, a West Virginia University epidemiologist who conducts community-based research on injection drug use, told Sisk, “You would think that in a state that had the worst HIV outbreak in the country, we would have a statewide testing strategy." Sisk reports, "Teague would like every rural county to have a mobile unit. . . offering harm reduction supplies, medication, behavioral health care, counseling, referrals, and more."

While disease prevention through syringe exchange programs is well documented, the CDC's health warnings and recommendations for improved access to syringe exchanges have been largely ignored. Sisk reports, "In April 2021, the state legislature passed a bill limiting the number of syringes people could exchange and made it mandatory to present a West Virginia ID."