Thursday, February 18, 2016

Cluster of HIV Infections Attributed to Unsafe Injection Practices — Cambodia, December 1, 2014–February 28, 2015

What is already known about this topic?
Unsafe medical injection practices have been reported in Cambodia during the last decade. Current national human immunodeficiency virus (HIV) prevalence estimates do not include HIV transmission risk associated with unsafe injection or blood transfusion. HIV testing and surveillance in Cambodia are focused on high risk groups, including men who have sex with men, persons who inject drugs, and commercial sex workers.

What is added by this report?
The largest cluster of new HIV infections ever attributed to unsafe injections among a general population was reported in a rural area of Cambodia; 2.7% of residents were infected. The outbreak was detected after increased demand for HIV testing by residents who perceived themselves to be at risk after exposure to an unlicensed provider of injections and intravenous infusions.

What are the implications for public health practice?
HIV prevention strategies that target specific populations often do not consider the risk for HIV transmission via unsafe injections in the general population. Further studies are needed to clarify HIV prevalence in general populations where HIV risk perception is low; quantify the risk for other bloodborne infections (e.g., hepatitis C) via unsafe injections; understand public demand for medical injections; and improve health care workers’ injection practices in the public and private sectors. Measures to reduce both the demand for unnecessary medical injections and the provision of unsafe injections are needed.

Below:  Number of persons (N = 242) infected with human immunodeficiency virus, by date of diagnosis — Roka Commune, Cambodia, November 9, 2014–February 28, 2015

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By:  Mean Chhi Vun1; Romeo R. Galang2; Masami Fujita3; William Killam4; Runa Gokhale2; John Pitman5; Dejana Selenic5; Sovatha Mam1; Chandara Mom1; Didier Fontenille6; Francois Rouet6; Saphonn Vonthanak7 
1Cambodia National Center for HIV/AIDS, Dermatology and STD; 2Epidemic Intelligence Service, CDC; 3World Health Organization, Cambodia; 4Division of Global HIV/AIDS, CDC, Phnom Penh, Cambodia; 5Division of Global HIV/AIDS, CDC; 6Institut Pasteur du Cambodge, Phnom Penh, Cambodia; 7Cambodia University of Health Sciences.

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