Mapping How The Opioid Epidemic Sparked An HIV Outbreak

Researchers knew the HIV outbreak in the small town of Austin, Ind., was related to IV drug use. Mapping how the virus mutated over time revealed its path — and how it might have been stopped.
Interviews with people in Scott County, Ind., identified people at high risk of HIV infection (blue circles), and people with HIV (red circles). Larger circles represent people with more high-risk contacts. Source: CDC/Oxford University Press

When people started to show up to Dr. William Cooke's primary care office in Austin, Ind., in 2014 with HIV, Cooke knew it was probably related to the region's opioid epidemic. But what he and the rest of the public health community didn't know was who they were missing or how long the HIV outbreak had been going on.

Now they've got a clearer picture — literally. In visualizations published in the Journal of Infectious Diseases, dots and lines define the constellations of Indiana's HIV outbreak. Using genetic sequencing, they show how long the outbreak had been going on, connected people who hadn't previously been linked by traditional methods, and showed how the virus jumped from a slowly spreading infection to a virus transmitted quickly via needle sharing and other, smaller sub-epidemics.

Genetic data has been used to track HIV before. But now, the technology

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