FAQ: HIV rates rise among people who use drugs

Updated June 27, 2019

Worrying trend in HIV

After years of declining HIV infections in Multnomah County, state and local public health officials are responding to an increase in new cases among people who use methamphetamines or inject drugs. The most common risk factor so far is drug use: using methamphetamine in any form or injecting any type of drug.

Who is at risk?

The most common ways people get HIV are through unprotected sex with someone with HIV, or using injection drug supplies previously used by someone with HIV. Health officials are particularly concerned about the risk to anyone who:

• Uses meth in any form

• Injects drugs of any type

• Men who have sex with men

• Sexual partners of any of the above

What should people do?

1. Get tested for HIV. Everyone has an HIV status. Get to know yours.

2. Multnomah County can help people who test positive for HIV to get medicines that suppress the virus.

3. Anyone who tests negative, and uses meth, shares drug injection supplies or has sex with people who do, should ask about PrEP, a medicine that protects against the virus.

4. Anyone who injects drugs should use a clean needle every time. There are many places to exchange used needles for new ones.

Haven Wheelock oversees the syringe exchange at Outside In, where people can get clean syringes, HIV testing and more.

Where can people get testing?

Many nonprofit and public clinics provide HIV and STD testing, regardless of an individual’s ability to pay, including:

• Multnomah County STD Clinic

• Multnomah County Harm Reduction Clinic

• Outside In

• Cascade Aids Project

• Washington County testing sites

• Clackamas County testing sites

• Clark County (Washington) testing sites

How can people prevent infection?

When you Shoot: Use clean needles, cookers, cottons, water, and other supplies when injecting drugs. Get free syringes and other supplies at area syringe exchanges and harm reduction clinics:

• Multnomah County and Outside In Syringe Exchange: Sterile injection supplies are distributed free at mobile syringe exchange sites across the county.

• Multnomah County Harm Reduction Clinic: Sterile injection supplies are distributed free Monday and Thursday, from 11 a.m. to 7 p.m., 12425 NE Glisan St.

• Portland People’s Outreach Project: Volunteer-run all-volunteer group provides clean syringes, Naloxone and other harm reduction supplies. PPOP is not operated or funded by Multnomah County.

Having Sex: Use condoms during sex to reduce chances of getting HIV. Safer sex supplies are distributed free through:

• Multnomah County and Outside In Syringe Exchange mobile sites.

• Multnomah County Harm Reduction clinic, Monday and Thursday, 11 a.m. to 7 p.m., 12425 NE Glisan St.

• Multnomah County STD Clinic

Get on PrEP: Pre-exposure prophylaxis is a medicine that lowers the chances of getting HIV.  People at risk for HIV can visit the Multnomah County STD Clinic to learn more. For people who cannot afford the medicine, staff can often help enroll in programs to pay for the drug.

Where can people get treatment for HIV?

Many nonprofit and public clinics provide HIV care, regardless of ability to pay.

If you have HIV and need help finding care, call Multnomah County Health Department at 503-988-3702, an HIV Medical Case Manager at the Partnership Project at 503-230-1202, or Cascade AIDS Project at 503-223-5907.

Condoms help protect against sexually transmitted diseases

Not Just HIV

The same factors that put people at risk for getting HIV are contributing to a local increase in other infections such as syphilis and shigella, and raising concern that our County could be vulnerable to a Hepatitis A outbreak.

About Syphilis

Syphilis is a contagious sexually transmitted bacterial infection spread through sex. It causes sores on or around the penis, vagina, or in the rectum, on the lips, or in the mouth. It can also pass from mother to unborn child. Syphilis can be cured with the right antibiotics.

Who is at risk?

Anyone who has sex can get syphilis. But health officials are most concerned about the risk for:

• People who use meth or any injection drugs

• Men who have sex with men

• Sexual partners of either of the above

• Pregnant women

Is Syphilis serious?

Syphilis causes sores and a skin rash. It can affect different body organs including the eyes and brain. Syphilis can cause lifelong health problems for babies born to women with syphilis who are not treated. In severe cases it can lead to stillbirth.

How can I protect myself?

Get tested for syphilis, especially if you are pregnant, using drugs, or a man who has sex with other men. Syphilis is curable with antibiotics. Using condoms during sex can help prevent contact with a syphilis sore.

About Shigella

Shigellosis is an infectious bacterial disease that causes diarrhea, fever, and stomach cramps. Some people who are infected may have no symptoms at all, but can still pass the bacteria to others when stool comes into contact with another person’s mouth.

Who is at risk?

Shigella is most often spread through intimate contact, especially sexual behaviors involving the mouth, anus and hands. Health officials are particularly concerned about the risk for:

• Men who have sex with men

• Anyone unstably housed

Is Shigella serious?

Shigella can be serious. For most people, it causes diarrhea, fever and stomach pain. But it can also lead to dehydration, hospitalization and, rarely, death.

How can I protect myself?

Wash hands whenever possible with soap and warm water.

If you or your sexual partners have diarrhea, wait to have sex for 3 weeks to keep from spreading the infection.

About Hepatitis A

Hepatitis A is a viral liver disease. The virus most often spreads through contaminated food and direct contact with an infectious person, either by sharing food or having sex. It causes fever, loss of appetite, belly pain, nausea and yellow skin.

Who is at risk?

Hepatitis A is transmitted by swallowing small particles of feces from an infectious person. Health officials are most concerned about the risk to:

• Men who have sex with men

• Anyone unstably housed

• Anyone using drugs

Is hepatitis A serious?

Hepatitis A does not cause long-term liver problems but it can be very serious, even deadly, for people who already have liver disease (for example from hepatitis C or alcoholic liver disease).

How can I protect myself?

A safe and effective vaccine provides protection against hepatitis A.

What is Multnomah County doing to help?

Multnomah County is carefully tracking increasing HIV, syphilis, shigellosis, and the potential for future spread of hepatitis A in vulnerable communities.

The Health Department is:

• Partnering with homeless service providers and outreach workers to distribute coupons for free HIV, syphilis and hepatitis A testing at the county’s STI and Harm Reduction Clinics.

• Increasing weekly outreach and field testing at area camps, and distributing coupons for free-tests, and safer sex and health kits.

• Increasing ability to see walk-in clients and test them at the STD Clinic in Old Town Portland and Harm Reduction Clinic in East Portland.

• Reaching out to HIV-positive individuals who use meth, are unhoused, and inject drugs to make sure they get good treatment for their HIV.

• Communicating directing with clinicians across the region, and responding to provider questions about testing, lab interpretation, and finding people who need to know their test results.

• Meeting weekly with state and other local health officials to track cases, coordinate services, and make sure our messages are up to date.