HIV/AIDS claim misses mark

Democratic U.S. Sen. Edward J. Markey said the Trump administration’s plan to use funds from HIV and AIDS programs to fight the opioid addiction crisis is unsound. Specifically, the Massachusetts senator said that increased opioid abuse has led to an increase in HIV and AIDS.

The administration’s Oct. 26 declaration of the opioid epidemic as a national public health emergency allows flexibility in the use of resources in HIV and AIDS programs to allow people eligible for those programs to get substance abuse treatment.

“The administration’s proposal to reallocate funding from HIV/AIDS programs to the opioid crisis is robbing Peter to pay Paul, especially as HIV and AIDS rates spike due to increased heroin and fentanyl use,” Markey said.

We wanted to know if increased use of heroin and fentanyl have led to increased rates of HIV and AIDS. We found some truth to Markey’s claim but not enough national data to fully back it.

U.S. opioid epidemic, transmitted diseases

More than 64,000 people died in 2016 from drug overdoses, the majority linked to opioids, which include the synthetic opioid fentanyl and the illicit drug heroin, according to the U.S. Centers for Disease Control and Prevention.

Increased availability, a relatively low price and the high purity of heroin in the United States are driving increased use of heroin, the CDC said. Fentanyl use, including illicitly made fentanyl, has also increased in recent years.

People who inject drugs are at risk for infectious diseases that can be transmitted through used needles and syringes.

Human immunodeficiency virus, or HIV, is most commonly acquired or transmitted through sexual behaviors and needle or syringe use. If not treated, HIV can lead to acquired immunodeficiency syndrome, or AIDS.

The CDC’s 2015 HIV Surveillance Report noted that HIV and AIDS diagnoses tied to injection drug use declined from 2010 to 2015. The report did not specify diagnoses by types of drugs injected.

From 2008 to 2014, estimated annual HIV infections among people who inject drugs declined 56% (from 3,900 to 1,700), according to February 2017 data from the CDC. That report did not include AIDS data.

HIV outbreak in southeastern Indiana

Experts we reached said they were not aware of reports showing a national spike in HIV and AIDS among injection drug users, but noted that data collection and reporting tends to lag.

“It is very possible that increased HIV transmission due to fentanyl and/or heroin use is occurring” but has not yet been identified through HIV testing and screening or has not yet been reported to CDC, said Brandon Marshall, an associate professor of epidemiology at the Brown University School of Public Health.

When we contacted Markey’s office, it highlighted reports about HIV spikes in Scott County, Indiana.

Scott County historically had fewer than five cases of HIV infection reported annually, CDC reported. By April 21, 2015, Indiana officials had diagnosed HIV in 135 people in a small community within Scott County.

Most of them reported injection drug use with oxymorphone as their drug of choice, said CDC’s May 2015 report, adding that some reported injecting heroin.

Since early 2015, at least 191 people had tested positive for HIV in Scott County, the Indiana State Department of Health said in April 2016.

A CDC analysis published November 2016 found that at least 220 counties in 26 states are “potentially vulnerable” to HIV and hepatitis C infections among persons who inject drugs “in the context of the national opioid epidemic.”

Our rating

Markey said HIV and AIDS rates have spiked “due to increased heroin and fentanyl use.”

There are risks for HIV transmission among people who share needles and syringes to inject opioids. An Indiana county recently had an HIV outbreak linked to the injection of opioids, including heroin. At least 220 U.S. counties may be at risk of similar outbreaks.

But the CDC said it does not have national data addressing Markey’s heroin and fentanyl claim, and estimates that HIV and AIDs diagnoses have declined in recent years among people who inject drugs.

Markey’s statement contains an element of truth but ignores critical facts that would give a different impression. We rate it Mostly False.