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April 9, 2021

W. Kent Carper
President, Kanawha County Commission
P.O. Box 3627
Charleston, West Virginia 25336

Dear Mr. Carper:

Thank you for your letter to Senators Capito and Manchin regarding your concerns related to the
HIV outbreak among people who inject drugs (PWID) in Kanawha County, West Virginia. The
Centers for Disease Control and Prevention (CDC) appreciates your engagement, and welcomes
the opportunity to work with you, the Kanawha-Charleston Health Department and the West
Virginia Bureau for Public Health in response efforts.

Working with state and local health departments, CDC’s domestic HIV program conducts
monitoring to detect and respond to HIV outbreaks across the United States. Since the beginning
of 2019, there have been more than 50 new HIV diagnoses among PWID living in Kanawha
County with 35 new HIV diagnoses identified among people who inject drugs in 2020. This is
considerably higher than the prior annual average of fewer than five new cases among PWID in
Kanawha County. Among U.S. counties with a population size similar to Kanawha County, the
average number of HIV diagnoses among PWID in 2019 was fewer than one. State and local
public health officials noted the significant increase in cases and responded with efforts to
expand prevention and care services. An outbreak of this size requires large-scale, sustainable
efforts to prevent further spread. CDC has been working with state and local health departments
to respond effectively.

Your letter requested additional information about data from New York City. New York City’s
most recent surveillance report shows that there were 36 new HIV diagnoses among PWID in
2019 (www1.nyc.gov/assets/doh/downloads/pdf/dires/hiv-surveillance-annualreport-2019.pdf).

CDC has been working with the West Virginia Bureau for Public Health and local partners to
understand the extent of the outbreak and support implementation of an effective response. CDC
stands ready to provide more support at the invitation of the state. CDC recognizes the hard work
and dedication of staff from Kanawha-Charleston Health Department, Charleston Area Medical
Center, the West Virginia Bureau for Public Health, and multiple local organizations working to
develop and implement response activities for this concerning outbreak and applauds their
continued dedication amidst the COVID-19 pandemic.
Page 2 – Mr. W. Kent Carper

We appreciate your interest in this important public health issue. CDC would be pleased to
further discuss the outbreak, needed response efforts and support, and effective prevention
options. Please share this response with the co-signers of your letter.

Sincerely,

Jonathan Mermin, MD, MPH


Rear Admiral and Assistant Surgeon General, USPHS
Director, National Center for HIV/AIDS, Viral
Hepatitis, STD, and TP Prevention, CDC

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