Rapidly growing clusters of ongoing HIV transmission in Texas

Rapidly growing clusters of ongoing HIV transmission in Texas

Provided by Texas Department of State Health Services

The Texas Department of State Health Services (DSHS) encourages Texas healthcare providers to enhance efforts to prevent, diagnose and treat HIV in the wake of 16 rapidly growing clusters of HIV infections in the state.

Laboratory analysis of these infections indicates sustained transmission of genetically similar types of HIV. Many of the persons within these clusters reported meeting sex partners through social media. The clusters are primarily comprised of gay men and other men who have sex with men, with evidence that active HIV transmission is ongoing.

Molecular surveillance (genotyping) is a new tool being used by the U.S. CDC to identify clusters of HIV infection. Recent analysis indicates that the 16 clusters identified in Texas are largely centered in the Houston, San Antonio and Dallas/Fort Worth metropolitan areas, but many have one or more persons within the cluster who reside in other locations in Texas. Cases are spread across more than 25 Texas counties. The clusters range in size from 5 to 34 cases, with over 200 cases being linked to the Texas clusters. However, as public health continues their work, it is likely that additional cases may be linked to these clusters.

DSHS requests that Texas healthcare providers consider adopting the following strategies in response to these findings:

Order HIV testing for patients with symptoms of possible acute HIV infection. Common symptoms of acute HIV infection include fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, swollen lymph nodes, and/or mouth ulcers. These symptoms can last several days to several weeks. Persons with acute HIV infection are highly infectious due to an elevated viral load.

Order NAAT or HIV RNA testing for patients with an indeterminate supplemental HIV test result. These tests can identify whether the virus itself is present in the blood before antibodies to the virus become detectable, allowing for earlier

Diagnosis of HIV infection.

Order HIV testing for all patients diagnosed with a sexually transmitted disease (STD).

Ensure all HIV testing follows CDC's HIV/AIDS Laboratory Testing Guidance.

Discuss pre-exposure prophylaxis (PrEP) with HIV-negative patients at increased risk of infection.

For more information, healthcare providers can contact their local health department, the DSHS HIV/STD Program at 512-533-3000, or the National Clinicians Consultation Network at (800) 933-3413.