Research and Evaluation

What’s Oxymorphone Got to Do With It?

High Risk Injection Practices Leading to an Outbreak of HIV in a Rural Community

From 2004 to 2013, only five people were diagnosed with HIV in Scott County. From December 2014 to January 2015, 11 people were newly diagnosed with HIV.

By October 28, 2016, 210 people were diagnosed with HIV.

  • All were linked to Austin, IN.
  • Nearly all had experience injecting OPANA® ER.
  • Infections were recent and from a single strain of HIV.
  • 199 (95%) co-infected with Hepatitis C.

Community Outbreak of HIV Infection Linked to Injection Drug Use of Oxymorphone — Indiana, 2015

On January 23, 2015, the Indiana State Department of Health (ISDH) began an ongoing investigation of an outbreak of human immunodeficiency virus (HIV) infection, after Indiana disease intervention specialists reported 11 confirmed HIV cases traced to a rural county in southeastern Indiana. Historically, fewer than five cases of HIV infection have been reported annually in this county. The majority of cases were in residents of the same community and were linked to syringe-sharing partners injecting the prescription opioid oxymorphone (a powerful oral semi-synthetic opioid analgesic). As of April 21, ISDH had diagnosed HIV infection in 135 persons (129 with confirmed HIV infection and six with preliminarily positive results from rapid HIV testing that were pending confirmatory testing) in a community of 4,200 persons (1).

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Risk Factors for HIV in an Outbreak Among Persons Who Inject Drugs, Indiana 2015

This poster aims to identify risk factors for HIV infection and inform control efforts.

  • In early 2015, an outbreak of HIV infections was identified in Scott County in rural southeastern Indiana.
  • Scott County reported <5 hiv="" infections="" in="" the="" last="" decade="" li="">
  • Investigation indicated that by July 31, 2015, a single strain of HIV had infected >170 persons in a matter of months, most of whom were persons who inject the prescription drug oxymorphone.
  • Scott County ranks 92nd in several health and social indicators among Indiana’s 92 counties including life expectancy.