People who inject drugs are being warned about an HIV outbreak in Glasgow and drug injecting practices that increase the risk of HIV transmission.
The significant advances made in HIV treatment over the last 30 years are also being stressed to encourage those at risk to get an HIV test and come forward for treatment.
There are, on average, 10 new cases of HIV diagnosed in the Greater Glasgow and Clyde area annually which are attributed to drug injecting.
However, last year saw a significant change with a very steep increase in new cases to 47. For the first time in almost 30 years new diagnoses of HIV related to injecting drug use are at a level comparable with those in men who have sex with men or in the heterosexual population.
The provision of free injecting equipment was introduced in the 1980s to reduce HIV transmission rates amongst people who inject drugs. As a result, and through opioid substitution therapy such as methadone, rates of HIV infection in this group have previously remained low in the board area.
Investigations into the outbreak have highlighted that some drug users are sharing needles, syringes, spoons and water when preparing and injecting their drugs. It has also highlighted that there is low awareness of the risks of HIV from doing so.
Whilst sharing needles and syringes will pose the highest risk of transmitting HIV, public health and drugs services are highlighting that HIV can also be transmitted through sharing or reusing flush water (water previously used in an attempt to clean syringes) or other paraphernalia such as spoons and filters.
Although there is no cure for HIV, there are now treatments which reduce the virus to undetectable levels. New guidelines highlight the importance of starting HIV treatment early. This is beneficial for the individual, but is also important in preventing the spread of HIV.
Dr Catriona Milošević, Consultant in Public Health Medicine, NHS Greater Glasgow and Clyde (NHSGGC), said: “There has been a significant outbreak of HIV in people who inject drugs in the NHSGGC area.
“While the focus of this has been in Glasgow, a wider population of people who inject drugs, and the services in contact with them, need to realise the potential for the spread of HIV.
“Firstly, people from other areas may travel to, and inject within, Glasgow. Secondly, the lessons from this outbreak highlight the potential for a similar situation to develop in other areas and the need for robust prevention efforts to prevent this.
“The outbreak highlights the potential for rapid spread of HIV in people who inject drugs. It is vitally important that if people are injecting drugs they don’t share, and ideally do not reuse, any equipment.
“This includes when injecting with close friends or partners – you can’t guess whether someone has HIV, and they may have no symptoms and be unaware themselves. Everyone involved needs to use a new set of sterile injecting equipment every single time, including needles, syringes, water, filters, and spoons, to protect themselves and others. These are all available from injecting equipment services.
“The ultimate goal for the NHSGGC is for drug users to recover from their addiction and remain drug free.
“However, until someone is ready to seek and receive help it is important to keep them as safe as possible while they continue to use drugs.
“For those who cannot stop using drugs there is extensive harm reduction, including alternatives to injecting, such as foil for smoking heroin, and injecting equipment provision.
“There is no cure for HIV. However, there are now very effective treatments available that control the virus – often involving only one tablet a day. Recent discussions have highlighted that those at risk are not aware of the huge advancements made in HIV treatment – there is still a perception that a diagnosis of HIV is a ‘death sentence’.
“If people are diagnosed and start treatment early, which requires a test, they can have a similar life expectancy as the rest of the population. Treatments reduce the virus to undetectable levels and mean those with HIV are less likely to be infectious to others.
“HIV testing is available in a range of health care settings and it’s essential that people who inject drugs get tested now and on a regular ongoing basis. Testing is the only way for people who inject drugs, or anyone at risk of HIV, to know their status.”