{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:22:01Z","timestamp":1792174921977,"version":"4.4.0"},"reference-count":63,"publisher":"Oxford University Press (OUP)","issue":"Supplement_5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>In 2015, a large human immunodeficiency virus (HIV) outbreak occurred among persons who inject drugs (PWID) in Indiana. During 2016\u20132019, additional outbreaks among PWID occurred across the United States. Based on information disseminated by responding health departments and Centers for Disease Control and Prevention (CDC) involvement, we offer perspectives about characteristics of and public health responses to 6 such outbreaks. Across outbreaks, injection of opioids (including fentanyl) or methamphetamine predominated; many PWID concurrently used opioids and methamphetamine or cocaine. Commonalities included homelessness or unstable housing, previous incarceration, and hepatitis C virus exposure. All outbreaks occurred in metropolitan areas, including some with substantial harm reduction and medical programs targeted to PWID. Health departments experienced challenges locating case patients and contacts, linking and retaining persons in care, building support to strengthen harm-reduction programs, and leveraging resources. Expanding the concept of vulnerability to HIV outbreaks and other lessons learned can be considered for preventing, detecting, and responding to future outbreaks among PWID.<\/jats:p>","DOI":"10.1093\/infdis\/jiaa112","type":"journal-article","created":{"date-parts":[[2020,3,12]],"date-time":"2020-03-12T20:21:43Z","timestamp":1584044503000},"page":"S239-S249","source":"Crossref","is-referenced-by-count":108,"title":["Responding to Outbreaks of Human Immunodeficiency Virus Among Persons Who Inject Drugs\u2014United States, 2016\u20132019: Perspectives on Recent Experience and Lessons Learned"],"prefix":"10.1093","volume":"222","author":[{"given":"Sheryl B","family":"Lyss","sequence":"first","affiliation":[{"name":"Division of HIV\/AIDS Prevention, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"US Public Health Service, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Buchacz","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS Prevention, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Paul","family":"McClung","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS Prevention, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"US Public Health Service, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Asher","sequence":"additional","affiliation":[{"name":"National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra M","family":"Oster","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS Prevention, National Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"},{"name":"US Public Health Service, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,9,2]]},"reference":[{"key":"2020101904352351600_CIT0001","article-title":"HIV diagnoses among people who inject drugs\u2014United States, 2010\u20132016.","author":"Lyss"},{"key":"2020101904352351600_CIT0002","author":"Centers for Disease Control and Prevention"},{"key":"2020101904352351600_CIT0003","doi-asserted-by":"crossref","first-page":"1445","DOI":"10.15585\/mmwr.mm655051e1","article-title":"Increases in drug and opioid-involved overdose deaths\u2014United States, 2010-2015","volume":"65","author":"Rudd","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2020101904352351600_CIT0004","doi-asserted-by":"crossref","first-page":"388","DOI":"10.15585\/mmwr.mm6817a3","article-title":"Drug overdose deaths involving cocaine and psychostimulants with abuse potential\u2014United States, 2003\u20132017","volume":"68","author":"Kariisa","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2020101904352351600_CIT0005","author":"Centers for Disease Control and Prevention"},{"key":"2020101904352351600_CIT0006","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1056\/NEJMoa1515195","article-title":"HIV infection linked to injection use of oxymorphone in Indiana, 2014\u20132015","volume":"375","author":"Peters","year":"2016","journal-title":"N Engl J Med"},{"key":"2020101904352351600_CIT0007","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2105\/AJPH.2019.305366","article-title":"Opioid use fueling HIV transmission in an urban setting: an outbreak of HIV infection among people who inject drugs\u2014Massachusetts, 2015\u20132018","volume":"110","author":"Alpren","year":"2019","journal-title":"Am J Public Health"},{"key":"2020101904352351600_CIT0008","author":"Tumpney","journal-title":"J Infect Dis 2020; 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