WV HIV CLUSTERS AND OUTBREAKS

Since January 2018, West Virginia has experienced a rise in HIV cases across the state, especially among people who inject drugs (PWID). In 2019, Cabell County was the center of a large HIV outbreak, and another large outbreak was found in Kanawha County among PWID late that same year. The number of new HIV diagnoses each year is still higher from injection drug use than from any other way people get the virus. Because of this, many of the activities and strategies created to fight these two large outbreaks are still in use in those communities. The lessons learned from these outbreaks are now being used throughout the state to help people who are most at risk.  

Cabell County HIV Outbreak

An increase in HIV cases among persons who inject drugs was first identified in late 2018, with formal response activities beginning in 2019.  Since then, the West Virginia Bureau for Public Health (BPH), Cabell-Huntington Health Department (CHHD), healthcare providers, and community partners have implemented a coordinated, data-driven response.  During 2019 response activities included a CDC Epi Aid, federally assigned Disease Intervention Specialists for case investigation and follow up, community education and information meetings, expansion of HIV testing in healthcare and non-traditional settings and Incident Command Structure to coordinate response activities.  Although several of the formal response activities from 2019 have been scaled back, increased testing and community outreach efforts continue to facilitate individuals knowing their HIV status and being linked to care, treatment, and other services for those who need it.  These activities and the dedication of the partners involved have created sustained improvements in stopping rapid transmission of HIV in Cabell county.  During the initial response in 2019, the average number of new HIV diagnoses was 16.75 each quarter, response activities have successfully lowered that number to 4 per quarter in 2025.  BPH and CHHD continue to monitor disease and care trends to adjust response activities as needed.

Kanawha County HIV Outbreak

 

Overview

An increase in HIV cases was identified in Kanawha County in 2019, with formal outbreak response activities beginning in late 2019. Since then, the West Virginia Bureau for Public Health (BPH), Kanawha Charleston Health Department (KCHD), healthcare providers, and community partners have implemented a coordinated, data-driven response. Based on sustained improvements, BPH and KCHD are closing the HIV outbreak.

Response Highlights (2019–2025)

  • CDC Epi Aid (2021): Medical chart reviews and interviews to guide response strategies
  • Incident Command Structure to coordinate response activities
  • Expanded HIV testing in healthcare and non-traditional settings
  • Mobile outreach services for testing and medical care
  • Federally assigned and state Disease Intervention Specialists (DIS) for case investigation
  • Linkage-to-care coordination meetings and strengthened referral networks
  • Increased community outreach staffing, including Vandalia Health Community Connect, formerly CAMC Ryan White Clinic 
  • Regular data reporting, media briefings, and County Commission engagement

Why the Outbreak Is Closing

  • New cases declined from an average of 11.25 per quarter in 2021 to fewer than two per
  • quarter in 2024 and 2025
  • HIV viral suppression exceeded 70% among outbreak-associated cases in 2025, comparable to statewide levels
  • Surveillance data show:
    • Low numbers of new cases
    • High treatment and viral suppression rates
    • No evidence of recent, rapid transmission
    • Laboratory indicators suggest infections occurred one to five years prior to diagnosis

What Closure Means

  • Closure reflects successful public health intervention, not the elimination of HIV risk
  • Formal response activities have already been gradually scaled back
  • Prevention, testing, treatment, and care services will continue

What Continues in Kanawha County

  • Expanded HIV testing, including mobile outreach
  • Ongoing linkage-to-care and treatment services
  • Statewide linkage-to-care nurse network for new and existing cases
  • Dedicated DIS staff focused on HIV case follow-up 
  • Established community services infrastructure through partners including:
    • WV HealthRight
    • CAMC Ryan White Clinic
    • Cabin Creek Health Systems
    • Covenant House

Ongoing Monitoring and Readiness

  • BPH conducts twice-monthly HIV surveillance analyses statewide
  • Monitoring uses laboratory data and reports from healthcare and community providers
  • If case numbers increase, formal outbreak response activities can be rapidly reactivated

Key Message

The closure of the Kanawha County HIV outbreak is a data-driven transition made possible by strong community partnerships. Continued testing, treatment, and outreach remain essential to sustaining progress and preventing future transmission.