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The CDC estimated that at the end of 2018, 1.2 million Americans were living with HIV; 186,500 of those cases were a result of intravenous drug use (HIV Surveillance Report, 2020). This is a growing trend, as 2,492 newly diagnosed HIV cases were reported among people who inject drugs. Many public health officials worry that the numbers will increase even more disproportionately as a result of the COVID pandemic.

The Southern United States experienced the largest increase in the number of reported HIV cases among users who inject drugs:

  • South – 976 cases
  • Northeast – 595 cases
  • West – 518 cases
  • Midwest – 375  cases
  • Dependent Territories – 28 cases

Outbreaks of HIV have been reported in Indiana, Massachusetts, Oregon, Pennsylvania, Washington State, West Virginia, and the Northern Kentucky/Cincinnati metropolitan area since 2015 (Journal of Infectious Disease). Officials blame the problem on sharing dirty needles and unprotected sex, two behaviors that have increased greatly since the onset of COVID.

The West Virginia Outbreak

Appalachia has not historically been a hotbed for HIV, so the recent cluster outbreaks in two West Virginia counties, Kanawha and Cabell, are particularly alarming:

  • There were 37 new HIV diagnoses in Kanawha County in 2020, primarily in the capital city of Charleston (Science Daily).

Cabell County went from 2 reported cases in 2018 to 82 reported cases through October 2019, which is 18% higher than the national estimated rate (Medpage Today). 

According to Medpage Today, nearly all the cases in Cabell County were attributed to injection drug users; nearly 9 out of 10 of those individuals also had hepatitis C. The demographics of the infected individuals reflect another new trend in HIV cases: 

  • 91% were white
  • 40% were women
  • The median age was 33

Cabell County is home to the city of Huntington, which serves as the metropolitan area for residents from nearby Ohio and Kentucky, as well as West Virginians. The region has been hard hit by the opioid crisis brought on by the collapse of the coal mining industry and poverty. As a result, West Virginia has experienced some of the highest rates of opioid use and death by opioid overdose in the nation.

COVID-19 has exacerbated the problem. Communities are using funds previously set aside for HIV, hepatitis, sexually transmitted disease (STD) testing, along with substance abuse outreach toward fighting the coronavirus pandemic. As a result, deaths by drug overdose increased by more than 40% in West Virginia, according to provisional data released by the CDC in March 2021. Between September 2019-August 2020, 1,147 West Virginians fatally overdosed on drugs, compared to 816 during the same 12-month in 2019.

Dr. Sally Holder, a leading infectious disease expert at West Virginia University and colleague and professor Judith Feinberg identified challenges in the ongoing fight to end the HIV epidemic (Science Daily):

  • Racial, sexual, and gender disparities
  • Gaps in domestic HIV program funding
  • Lack of access to treatment and prevention services
  • Economic barriers

The US is focusing its collective efforts to address all of these challenges. Experts across the country are tackling health equity. The American Relief Plan greatly expands access to affordable healthcare by extending open enrollment and providing financial subsidies to make health insurance affordable for low income individuals and families. Identifying and enrolling community members who are eligible for health insurance and enrolling them in plans that link them to the care they need should be a high priority for all communities.  

Community-based organizations are uniquely situated to identify the individuals who are eligible for healthcare coverage under the expanded plan. As substance abuse outreach and HIV testing efforts ramp up, you can identify those without insurance and help get them enrolled. If you are providing the COVID vaccine, you can provide enrollment information to those without health insurance. And if you aren’t currently offering vaccination services, you can become a mass immunization site and reach community members who might not otherwise have access.

American Exchange is Here to Help

Community organizations have limited resources. By partnering with American Exchange, you can focus your efforts on outreach and providing care.  

Enrollment and Billing Services

When your organization enrolls clients in Affordable Care Act (ACA) plans, you are not only improving the health of those individuals, you are creating a steady revenue stream that allows you to expand services and reach more community members. American Exchange can help you achieve both goals. We have successfully put more than 60,000 unique individuals and families on the road to good health by enrolling them in ACA health plans. We also help them understand how to access the comprehensive care they need to address comorbidities and improve their overall quality of life. And we help numerous public health agencies bill Medicare, Medicaid, TRICARE, and commercial insurers get reimbursed for the health services you provide. 

HIV Subsidy Programs

We specialize in providing enrollment and billing services to HIV subsidy programs across the nation. We have worked with Ryan White programs in Florida, Georgia, Illinois, Kansas, Mississippi, Missouri, New Hampshire, South Carolina, and  Tennessee.

We’ve connected more than 20,000 people living with HIV/AIDS to health plans that address all their medical needs, enabling them to adhere to medication regimens and live long and healthy lives. 

COVID Administrative Service

American Exchange is helping state and local health departments across the country become mass immunizers. We are a leading provider of COVID administrative support services, helping state and local health departments and community organizations like yours. We can assist you in becoming a mass immunizer and can bill for vaccine administrative services.   

Call American Exchange today at 1.888.995.1674 or by emailing to quickly get your clients enrolled in ACA plans so they have access to the medical services they need to address their whole health.