BOSTON (AP) — Massachusetts officials alerted health care providers to test frequently for HIV and to quickly report new infections to the Public Health Department.

Officials discovered that there were 182 intravenous drug users who were affected in Lowell and Lawrence between 2015 and 2019, The Boston Globe reported. The number of cases dropped after the summer of 2018 after a campaign to increase access to treatment.

There were six new cases diagnosed in Boston in December 2018 before a similar campaign was launched, and cases dropped down until fall of 2019.

“We do seem to see a growing number of very, very vulnerable people with substance use disorder, with injection drug use, in great need for care,” said Dr. Jennifer K. Brody, director of HIV services at the Boston Health Care for the Homeless Program.

The state has increased the number of needle exchanges from five in 2015 to 33, in an attempt to provide clean injection supplies and training, the paper reported. Infections among people who inject drugs declined 91% between 2000 and 2014.

“What we’re seeing is the need for much more aggressive street outreach,” said Carl Sciortino, vice president of government relations for Fenway Health.

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