A Case of Northern Overexposure

By: Marcus J. Hopkins, Blogger

The face of Hepatitis C (HCV) continues to change, as the State of Alaska Section of Epidemiology is reporting – nay, warning – of yet another example of rapid increase in HCV rates among people aged 18-29 (State of Alaska, 2016). Of the 1,486 cases of HCV reported in 2015, the aforementioned age group represented 459 of those cases – roughly 31% – putting them on par with people aged 30-49 (461, roughly 31%). The remaining cases in 2015 were seen in people aged 50 or older.

This data conforms to national trends in HCV. While the majority of cases tend to occur within the 50+ age range, the fastest rate of increase continues to exist amongst the young, largely driven by opioid prescription drug and heroin abuse. Injection Drug Use (IDU) is consistently pegged as the largest driver of new infections, and the problem continues to grow and more people are being prescribed addictive prescription opioid drugs for pain management for injuries that may not necessitate them.

While opioid and heroin IDU is a growing problem, Alaska has long been utilizing Harm Reductions methods to attempt to mitigate the harm to IDUs. Four Syringe Exchange Programs (SEPs) are currently operating in Alaska in four cities: Anchorage, Fairbanks, Homer, and Juneau. Only once of these cities – Juneau – is present in the hardest hit region of the state, where the rate of infection for 18-29-year-olds saw a 490% increase from 2011-2015. Of further concern is that no SEP programs are operative in other parts of the state, which means that people in those areas are least likely to receive IDU support services.

The State of Alaska is quick to state that these data should not be considered the final word on HCV infections for 2015; many people who are infected with HCV are not diagnosed until years after the initial infection (Juneau Empire, 2016).

In similar news, Clark County in Indiana has become the sixth county in the state to qualify for permission to open an SEP under a 2015 emergency law that allows states to open an approved exchange if the state’s health commissioner declares a public health emergency in the county (. This was in response to a massive outbreak of HIV and HCV in southern Scott County in late-2014/early-2015 related to IDU.

While Clark County has received approval for the opening of an SEP, it spent a full eight months attempting to work out issues with its initial application. The primary issue, according to County Health Commissioner Kevin Burke, was that state officials didn’t support how the SEP would have been funded. Funding for the program was and will be provided by the Los Angeles-based AIDS Healthcare Foundation (AHF), which has garnered both high praise and sharp criticism in its approach to negotiating contracts with states and counties. After the problematic funding models were hammered out, a second application was submitted and approved.
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Disclaimer: HEAL Blogs do not necessarily reflect the views of the Community Access National Network (CANN), but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about Hepatitis-related issues and updates. Please note that the content of some of the HEAL Blogs might be graphic due to the nature of the issues being addressed in it.

 

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