Opioids have sparked an HIV outbreak in Massachusetts

Despite Massachusetts' strong local health systems, near-universal health insurance coverage, and one of the best HIV and hepatitis C surveillance systems nationwide, the cities of Lowell and Lawrence have seen a spike in new HIV cases among people who use I.V. drugs.

Despite Massachusetts' strong local health systems, near-universal health insurance coverage, and one of the best HIV and hepatitis C surveillance systems nationwide, the cities of Lowell and Lawrence have seen a spike in new HIV cases among people who use I.V. drugs. There were 129 new HIV cases tied to drug use in the two cities between 2015 and 2018, according to preliminary results from a joint investigation by CDC and the Massachusetts Department of Public Health. From 2012–14, an average of just 41 cases of HIV connected to I.V. drug use were diagnosed per year in the entire state. The report found that key factors contributing to the outbreak may reflect nationwide trends. For example, investigators discovered that Lawrence had a local illegal fentanyl manufacturing operation, which made the synthetic opioid both rampant and cheap—exacerbating the spread of HIV because fentanyl's short high means it is injected frequently. In addition, widespread homelessness disrupted treatment for those most at risk, and clean needle exchanges were not established in either city until after the outbreak began. Other areas of the country with the same risk factors should prepare for a similar outbreak, experts warn. "If it can happen in Massachusetts, which has all the support in the world and all the services in the world, it can happen anywhere," said Judy Lethbridge, quality coordinator at Lowell Community Health Center.