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Officials say those experiencing homelessness and hard drug users are at greatest risk for infection

COURTESY MULTCO - Dr. Jennifer Vines, the deputy health officer for Multnomah County, speaks during a news conference regarding HIV infections on Thursday, June 20. Multnomah County is ringing the alarm bell over rising rates of HIV, syphilis and other infectious diseases.

"We don't know yet if this is a short-term increase or longer-term trend," said Dr. Jennifer Vines, the county's deputy health officer. "The hope is that more testing will link people to the care they need and stop the spread to others."

Forty-two people who self-identify as hard drug users have been diagnosed with the human immunodeficiency virus in the past 18 months — compared to 25 combined cases in 2016 and 2017. Of the 42 people, about half had tested negative for HIV within two years.

"The most common risk factor so far is drug use: using methamphetamine in any form or injecting any type of drug," according to a news release. "Many of the individuals newly found to have HIV are experiencing homelessness."

Unprotected sex is a related risk factor. HIV leads to AIDS, for which there is no cure, though advances in anti-retroviral therapy now allow most patients to greatly slow the syndrome.

Free tests for sexually transmitted diseases are available at a number of sites, including Multnomah County clinics at 619 N.W. 6th Ave. and 12425 N.E. Glisan St. The Cascade Aids Project offers testing at 2236 S.E. Belmont St., as does Outside In at 1132 S.W. 13th Ave.

Residents in Washington, Clackamas and Clark counties can also receive the tests at public health centers.

Syphilis rise

Though cases of syphilis have been trending upward for a decade, Multnomah County epidemiologists say there is an especially "sharp" spike in cases now.

There were 52 new diagnoses in 2017 — 87 in 2018 — and the 2019 total is expected to be even higher.

"(We) are recomending syphilis testing among men and women who use drugs, and men who have sex with men," officials say.

Syphilis, a sexually transmitted disease, can be cured with antibiotics.

Other infections

In a sequel to the Portland-area outbreak of 2015-16, doctors are reporting a rise in shigella — a bacterial diarrheal disease often spread through anal or oral sex, or by those without access to hygiene facilities.

County officials say "until recently" there were usually about 20 diagnoses a year, but 95 were recorded locally in 2018. Many of the shigella patients have also contracted HIV.

Most people recover from shigella without treatment, but severe cases are difficult to fight because shigella has developed resistance to several common antibiotics.

Hepatitis A is not on the rise in Multnomah County, but officials are still encouraging homeless people, men who have sex with men and hard drug users to make sure they have been vaccinated.

"Multnomah County Health Department is asking that local healthcare providers take every opportunity to give Hepatitis A-containing vaccine to non-immune adults," according to the release.

Should I be tested?

Multnomah County shared this list of risk factors for contracting HIV:

• Are sexually active gay and bisexual men — with some sexually active gay and bisexual men potentially benefiting from more frequent testing (every 3 to 6 months).

• Have had sex with an HIV-positive partner.

• Have had more than one sexual partner since their last HIV test.

• Have shared syringes, needles, and/or equipment to inject drugs.

• Have exchanged sex for drugs, money, food, or housing.

• Have had another sexually transmitted disease, hepatitis infection, or tuberculosis

• Have had sex with someone whose sexual history is not known.

• Based on local disease patterns, anyone with a recent Shigella diagnosis.

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