HIV outbreaks among people who inject drugs in Europe, North America, and Israel

Don C. Des Jarlais*, Vana Sypsa, Jonathan Feelemyer, Adrian O. Abagiu, Vic Arendt, Dita Broz, Daniel Chemtob, Carole Seguin-Devaux, Joan M. Duwve, Margaret Fitzgerald, David J. Goldberg, Angelos Hatzakis, Raluca E. Jipa, Eugene Katchman, Eamon Keenan, Ibrahim Khan, Stephanie Konrad, Andrew McAuley, Stuart Skinner, Lucas Wiessing

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

58 Citations (Scopus)


During 2011–16, HIV outbreaks occurred among people who inject drugs (PWID) in Canada (southeastern Saskatchewan), Greece (Athens), Ireland (Dublin), Israel (Tel Aviv), Luxembourg, Romania (Bucharest), Scotland (Glasgow), and USA (Scott County, Indiana). Factors common to many of these outbreaks included community economic problems, homelessness, and changes in drug injection patterns. The outbreaks differed in size (from under 100 to over 1000 newly reported HIV cases among PWID) and in the extent to which combined prevention had been implemented before, during, and after the outbreaks. Countries need to ensure high coverage of HIV prevention services and coverage higher than the current UNAIDS recommendation might be needed in areas in which short acting drugs are injected. In addition, monitoring of PWID with special attention for changing drug use patterns, risk behaviours, and susceptible subgroups (eg, PWID experiencing homelessness) needs to be in place to prevent or rapidly detect and contain new HIV outbreaks.

Original languageEnglish
Pages (from-to)e434-e442
JournalThe Lancet HIV
Issue number6
Publication statusPublished - Jun 2020


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