HIV and AIDS cases are on the rise in Kentucky; officials blame lack of education and increase of heroin use

Despite readily available information and awareness about practicing safe sex, and avoiding sharing needles, HIV and AIDS cases are on the rise in Kentucky. And the reason, say officials, is ignorance and an increase in heroin use, Mary Meehan reports for the Lexington Herald-Leader. Mark Royse, executive director of AVOL, which serves clients with HIV and AIDS in 72 Kentucky counties, said "his nonprofit routinely offers support services, including housing assistance, to about 400 families affected by HIV and AIDS."

Lauren Kirk, HIV and AIDS outreach specialist for the Lexington-Fayette County Health Department, "said a lot of the people they see are young and were born after the AIDS epidemic was at its lethal peak," Meehan writes. Another specialist, John Moses, told hr that the health department is seeing more young people with HIV. Part of that surge, he said, is from the use of shared needles as heroin use in Kentucky is on the rise." Heroin drug deaths in Kentucky increased by 550 percent in 2012, John Cheves reports for the Herald-Leader.

Another problem is that many people refuse to get tested, because discussion of HIV and AIDS includes talk of sexuality, homosexuality and drug abuse, Meehan writes. Royse told her, "It is a perfect storm of things we don't like to talk about." Royse said "a 'silence-is-better' policy is especially prevalent among Latinos and blacks, who account for the majority of new infections in Kentucky. He's concerned that if people stop talking about HIV and AIDS and become complacent, the infection will continue to spread." (Read more)

The state Cabinet for Health and Family Services, in its annual report from June, 2012, said 8,513 Kentuckians are diagnosed with HIV, with 7031 men and 1,482 women. Most of the cases are in urban areas, with 3,849 in Jefferson County and 1,099 in Fayette County. Of those cases, 4544 are classified as from men having sex with men (MSM), 917 as injection drug users (IDU) and 425 as people who reported to having engaged in both MSM and IDU.

The overall total of HIV and AIDS cases includes 21 boys under 13 years old, 107 between ages 13-19, and 1,269 between ages 20-29. For women, it includes 13 girls under 13 years old, 39 between ages 13-19, and 203 between ages 20-29. (Cabinet graphic: Newly diagnosed HIV cases in 2010 for Kentuckians ages 20-29 years old accounted for 32 percent of all new cases, even though that age group only makes up 13 percent of the total population)

Kentucky ranks 25th in HIV infections. In 2010, the state had 85 new HIV cases for people ages 13-24, accounting for 25 percent of all new cases in the state, which is higher than the national average for that age group of 21 percent. The average age of Kentuckians diagnosed with HIV went down from 37.1 years of age in 2006 to 35 years of age in 2010. To read the full report click here.

UK researcher calls for change in state law to allow syringe exchange program to curb hepatitis C epidemic in Eastern Ky.

Despite the benefits associated with syringe- or needle-exchange programs in preventing the spread of hepatitis C, Kentucky law still prohibits them, and a researcher from the University of Kentucky is calling upon policymakers to help curb this public health threat in Eastern Kentucky.

Syringe exchange programs were first created 30 years ago in response to the AIDS epidemic, and they are an important component of a comprehensive disease prevention strategy, says the Center for Disease Control and Prevention. Yet, Kentucky law prohibits them even though federally funded programs have successfully reduced disease transmission.

A recent study of 500 Appalachian drug users found that nearly two-thirds of them were infected with hepatitis C, reports Stu Johnson of WEKU News. Transmission of the disease in rural Appalachian communities is predominantly due to injection drug use, but community opposition and legal restrictions are barriers to establishing exchange programs.

UK epidemiologist Jennifer Havens would like to see a change in the state law to establish syringe exchange programs in Kentucky. She says these programs don't encourage drug use, which has in the past been an incorrect perception that can inhibit exchange adoption, says the CDC. The programs can instead reduce disease transmission.

“I don’t think anyone walking by the program, the syringe service program, is going to say, `I’m going to start doing drugs today because there’s a syringe service program.’ All it does is allow folks who are already injecting a safer way, a safer source of syringes and potentially program that they wouldn’t otherwise be able to access,” Havens told Johnson.

Haven's previous research, which examined individual and network factors among Appalachian drug users, found an association between injection of prescription opioids and hepatitis C. The study concluded that efforts preventing drug users' transition to injection, especially among prescription opioid users, may curb transmission of the disease. 

One public health tool that has successfully reduced disease transmission in other states is the creation of a syringe exchange program, says the CDC. In addition to asking for a policy change, Havens is calling for federal funding to establish syringe exchange programs in an area of Kentucky particularly impacted by the disease: the eastern region.

“In talking to a lot of the leaders in Eastern Kentucky, I haven’t necessarily approached this issue in particular, but they are at their breaking point with regard to what do we do about this epidemic, so I think, actually at the end of the day, a syringe service program would probably be fairly welcome,” Havens told Johnson.

Beyond reducing the spread of hepatitis C, syringe exchanges can also bring abusers into drug treatment programs, says Havens. The programs are reported to effectively link hard to reach drug users with prevention services, such as screening and drug abuse/ recovery programs, says the CDC. 

Kentucky expands list of permanent locations for safe disposal of unneeded or expired prescription medications

Gov. Steve Beshear announced today that Kentucky now has 149 permanent prescription drug disposal locations in 97 counties where Kentuckians can safely dispose of unused or expired medications in order to help curb the state's prescription drug abuse problem.

“The effects of prescription drug abuse are devastating to our families and our communities,” Beshear said in a news release. “Medications, once they are no longer needed for their prescribed purposes, should be disposed of properly to reduce their risk of being diverted and abused . . . "

Counties with permanent disposal boxes are shown on the map below in green. The boxes are monitored to ensure safe drug disposal and are located in law enforcement buildings. There are two pending locations, one in Ohio County and one in Franklin County, as shown in light blue. The 23 counties in white do not have permanent disposal locations.

“One in five of our Kentucky teens has abused prescription medication for an off-label purpose, and that abuse is starting in the home when children have access to their parents’ unused or expired pain medications,” Attorney General Jack Conway said in the news release.

The disposal boxes are funded by Kentucky Agency for Substance Abuse Policy, Operation Unite, Kentucky League of Cities and state and local law enforcement agencies, says the release.  Click here for a complete listing of locations and hours of operation.

As prescription painkillers become harder to get and abuse, heroin replaces them in Eastern and Southern Kentucky

Heroin use, which has been a problem in Northern and then Central Kentucky after the state began cracking down on prescription painkillers last year, has been spreading to the Southern and Eastern parts of the state. Heroin is becoming more popular throughout Kentucky because it is cheaper and easier to get than prescription painkillers, specifically opioid medications, reports Valarie Honeycutt Spears of the Lexington Herald-Leader.

While an 80-milligram OxyContin costs between $60 to $100 a pill on the black market, heroin costs $45 to $60 for a multiple-dose supply, reports The Partnership at Drugfree.org.  With national and state efforts to curb prescription drug abuse, including the reformulation of OxyContin that makes the drug more difficult to crush and snort, heroin can also be easier to obtain and abuse.

As drug users turn from prescription drugs to heroin to get their high, Northern Kentucky and major cities like Lexington and Louisville are struggling to address the problem, says an Operation UNITE press release. Operation UNITE is a regional anti-drug coalition fighting substance abuse in Southern and Eastern Kentucky counties (map).

Most Southern and Eastern Kentucky counties are just beginning to see the signs of heroin use, says the release. Dan Smoot, CEO of Operation Unite, told Spears that heroin’s spread throughout Kentucky was inevitable. “We knew it was coming. We just didn’t know when it would hit,” he said.

Rowan County was hit before most Eastern Kentucky counties, said Smoot; the most recent example of increased heroin use occurred July 9, when Operation UNITE agents arrested a known prescription drug trafficker attempting to bring a large quantity of heroin into Beattyville, says the release.

Uncertainty about what heroin users are actually getting makes the drug especially dangerous, says Paul Hays, law-enforcement director for Operation UNITE. “You don’t know the purity of the heroin,” he said in the release. “Dealers will often ‘cut’ the drug with other substances in order to boost their profits. There’s no way the public knows what they’re shooting up.”

This increased risk can be deadly, and although there's no evidence of an increase in heroin overdose deaths in Eastern Kentucky, a task force has been created to address this fatal problem in Lexington. There have been 29 heroin overdose deaths in Fayette County so far this year, seven more than the amount of overdose deaths in all opf 2012, Fayette Coroner Gary Ginn told the newspaper.

Read more here: http://www.kentucky.com/2013/07/22/2726235/heroin-problem-surfaces-in-southern.html#storylink=cpy