A collaborative program aimed at preventing new HIV infections in Kentucky, as well as expanding education and care for persons living with HIV, is being launched in Northern Kentucky and throughout the Commonwealth. 

In 2018, there were 352 new HIV cases diagnosed in Kentucky with 46 of the cases in the Northern Kentucky Area Development District (ADD), where the rate of infection has doubled since 2014. In January 2018, a cluster investigation was initiated in Northern Kentucky because there was a shift in identified risk factors to injection drug use in those newly diagnosed, according to the Kentucky Department for Public Health.

The Kentucky Cabinet for Health and Family Services' Department for Public Health (DPH) and the University of Kentucky have established the Kentucky Income Reinvestment Program (KIRP) to improve health care delivery via disease education, prevention, treatment and professional services for persons living with HIV through collaborations with existingRyan White HIV/AIDS funded programs and harm reduction programs at our local health departments.

“This collaborative partnership will strengthen our capabilities to combat the spread of HIV in the region,” said Dr. Jeff Howard, Commissioner of DPH. “With the increasing number of HIV cases linked to injection drug use, it is imperative we enhance services, education, and outreach to vulnerable populations and prevent further spread of infectious disease. This program is a first step in creating a more innovative approach to reaching at-risk populations, strengthening our public health approaches to disease prevention and providing improved care.”

The initiative will include pilot programs to fund innovative projects throughout the state to address access to care and supportive services for people living with HIV and those at highest risk. In addition to seeking to prevent new HIV cases, the program also will educate existing health care providers and health professions students in training to address substance use disorders and mental health issues that hinder effective HIV and medical care. 

“This program is especially important in the Commonwealth which has been hit so hard by the opioid epidemic, said Dr. Alice Thornton, UK College of Medicine’s chief of the Division of Infectious Disease. “We hope to offer opportunities to educate current and future medical health providers in screening and treatment of populations such as those with and at risk for HIV, Hepatitis A, B and C, substance use and sexually transmitted diseases.”   

The spread of HIV through injection drug use is a growing concern for public health officials. According to data collected by DPH, in Northern Kentucky, HIV cases with injection drug use as a risk factor increased from two reported cases in 2014 to 29 cases in 2018. Statewide, the number of HIV cases with injection drug use as a risk factor increased from 22 cases to 67 cases during the same time period. 

One of the goals of this initiative is to address workforce issues related to vulnerable populations. A key component of the program is the Harm Reduction Initiative which embeds Risk Reduction Specialists in the Harm Reduction/Syringe Exchange programs throughout the state to provide screening, comprehensive education and care for persons at highest risk for contracting and transmitting HIV and Hepatitis C.  

“This partnership and infusion of resources into Northern Kentucky is happening at a crucial time, said Dr. Lynne Saddler, District Director of Health at the Northern Kentucky Health Department. “With the CDC’s recent recommendations to us for addressing our increase in HIV infections among people who inject drugs, this initiative will enable us to expand and enhance our efforts to prevent new infections and to provide more comprehensive services to those who are infected. We are grateful for this opportunity.”

The Northern Kentucky Health Department will use the program funds for prevention education as well as support for syringe access exchange programs and outreach activities to expand testing locations and linkage to care for HIV and Hepatitis C. The program will also provide peer support specialists and help address substance use and mental health issues and client services for people who are HIV positive.

 "The platform of Harm Reduction is broad and this initiative will now address so many important issues in a proactive and progressive manner," said Dr. Ardis Hoven, infectious disease specialist and medical director for the KIRP Harm Reduction Initiative. "HIV prevention and diagnosis, serious co-infection prevention, opioid use challenges and linking people to appropriate care in a timely manner are all imperatives for our activities."