HEALTH authorities must guard against complacency and put extra resources in place to ensure Glasgow does not see a second spike in HIV infections, it has been claimed.
Last week a study by blood-borne virus researchers from Glasgow Caledonian University (GCU) and Health Protection Scotland (HPS), suggested a rise in cocaine injecting and homelessness were behind a tenfold increase in HIV infection among drug users in Glasgow between 2011 and 2018.
The Glasgow city-centre outbreak, which has been largely brought under control, is the UK’s largest in more than 30 years. However lead researcher Dr Andrew McAuley, of GCU and HPS, told the Sunday National additional resources along with better access to opiate replacement therapy – such as methadone – were needed to contain the outbreak.
“There is a still a huge risk in Glasgow as so many people are injecting in public places,” he said. “There is always a risk of a second wave.”
He claimed that of the 130-140 cases in the city, over 90% were in treatment, and paid tribute to the work of the city’s outreach nurse. However he added: “The system has been great but it’s fragile.
“There is no suggestion of a second spike at this stage but we need to guard against complacency. The case for a consumption room has never been clearer. At the moment people are injecting in alleyways, in tenement closes and bin shelters. We need to make a space available for them to access sterile equipment and facilities. The evidence that they work is compelling.” The plan has been ruled out by the Home Office.
Needle exchange provision could also be improved, he claimed, arguing plugging the gap left by the closure of the city’s busiest needle exchange service in Glasgow’s Central Station, which closed in 2017, with a mobile van “only goes so far”. “I know the health board are looking at it,” he added.
More action on tackling homelessness was also needed, he said. The city council is currently rolling out a Housing First model which aims to provide accommodation immediately and put necessary support around that. Heroin-assisted treatment is also due to roll out in the city in coming months.
David Liddell, chief executive of the Scottish Drugs Forum, said that there were several improvements that could be made, as well as lessons to learn from how the 1980s outbreak was contained in Scotland.
“The most vulnerable should be able to access a prescription for opioid replacement therapy (ORT) in hours rather than weeks,” he said. “Secondly, people should be on appropriate doses of methadone or buprenorphine as recommended by
the World Health Organisation and in professional clinical guidance. Presently as many as half of patients on ORT are on less than minimum doses and so will be vulnerable to topping up by injecting street drugs – and so at risk of HIV.”
He claimed due to scores of deaths associated with the use of street Valium among long-term heroin users, authorities are now considering whether benzodiazepines should be provided. Others have argued for increased investment in recovery networks, insisting that medial solutions will never be enough in themselves.
Public Health Minister Joe FitzPatrick insisted that prevention of HIV infection remained a priority for the Scottish Government. “There is absolutely no room for complacency,” he added. “These issues underline why we support Glasgow Health and Social Care Partnership’s proposals to introduce a medically supervised consumption facility. We must be willing to back innovative, evidence-based approaches that can make a real difference to people’s lives.”
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