"From 2015 to 2018, HIV prevalence among PWID [People Who Inject Drugs] in selected MSAs [Metropolitan Statistical Areas] was unchanged at 7%. This analysis found a higher HIV prevalence among Black PWID than among Hispanic or White PWID, despite fewer reported risk behaviors associated with HIV infection among Black PWID. In 2018, when compared with Hispanic or White PWID, fewer Black PWID shared syringes or injection equipment and had condomless anal sex. Overall, SSP use did not significantly increase since 2015 (from 52% to 55%), but a substantial decrease in SSP use among Black PWID (from 51% to 40%), and significantly lower use of SSPs in 2018 among Black PWID compared with Hispanic and White PWID was observed. Lower SSP use among Black PWID in the context of disproportionally higher rates of HIV diagnoses in Black communities (1) might lead to increased risk for HIV transmission among Black PWID. It is critical to explore and address the causes for these disparities in SSP use and HIV infection rates.

"In 2020, the COVID-19 pandemic impeded delivery of prevention services for PWID nationally, resulting in a substantial reduction in SSP operations and provision of medication for opioid use disorder (4). This analysis highlights the ongoing need for risk reduction and improved access to HIV prevention services among PWID than existed before the COVID-19 pandemic, especially because access to these services was reduced as a result of the pandemic. Findings from this analysis and continuous monitoring of characteristics and risk behaviors associated with HIV infection of PWID will facilitate estimation of how the pandemic disrupted behaviors as well as access to essential prevention services among PWID."


Handanagic S, Finlayson T, Burnett JC, Broz D, Wejnert C. HIV Infection and HIV-Associated Behaviors Among Persons Who Inject Drugs — 23 Metropolitan Statistical Areas, United States, 2018. MMWR Morb Mortal Wkly Rep 2021;70:1459–1465. DOI: dx.doi.org/10.15585/mmwr.mm7042a1.