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HIV Prevention Program

Basics on HIV Prevention

AIDS.gov and the CDC offer a wide variety of prevention resources:

HIV Risk Estimator

The HIV Risk Reduction Tool image at left links to information about the HIV risk of different sexual activities when one partner is HIV positive and one partner is HIV negative.

Get Tested for HIV

Each county health department in Kentucky now offers rapid screening for HIV with results available in 15-20 minutes. Several community-based organizations and health centers also offer rapid HIV testing.

Complete list of rapid HIV testing sites in Kentucky.

For more information about HIV tests, see the NIH AIDSinfo page.

Kentucky Syringe Exchange Programs

What Are Syringe Exchange Programs (SEPs)?

Syringe exchange programs (SEPs) have existed and been studied extensively in the United States since 1988. SEPs are community-based programs that provide access to sterile needles and syringes free of cost, facilitate safe disposal of used needles and syringes and offer safer injection education. SEPs in Kentucky also provide linkages to critical services and programs, including substance use disorder treatment programs; overdose prevention education; screening, care and treatment for HIV and viral hepatitis; prevention of mother-to-child transmission; hepatitis A and hepatitis B vaccination; screening for other sexually transmitted diseases and tuberculosis; partner services; and other medical, social and mental health services.

In direct response to Senate Bill 192 enacted during the 2015 regular legislative session, the Kentucky Department for Public Health has published guidelines for local health departments implementing harm reduction and syringe exchange programs.

SB 192 impacts KRS 218A.500/510

Why Does Kentucky Need Syringe Exchange Programs?
Syringe exchange programs are designed to mitigate a number of public health issues, including emergence of a new HIV epidemic. An Indiana town near Louisville recently had an HIV outbreak among people who inject drugs. Austin, Ind. now has HIV rates comparable to those in sub-Saharan Africa. Undoubtedly, this outbreak will cost Indiana millions of dollars to treat the new HIV infections.

Nearly half of Kentucky’s counties are at risk of an HIV outbreak
Recently the CDC analyzed every county in the United States to determine how vulnerable others might be to an HIV outbreak like the one in Indiana. Of the 220 counties across the US identified as highly vulnerable, 54 are in Kentucky (see map below). Kentucky has also had some of the highest rates of hepatitis C in the nation for several years. This is foretelling, because most of these new hepatitis C infections are from people who inject drugs and share needles, cookers and other contaminated equipment. Hepatitis C rates like those in Kentucky are seen as the canary in the coal mine for an HIV outbreak. SEPs have proven capable of reducing the chance of an outbreak.


Counties Vulnerable to HIV Outbreak and Preventive Syringe Exchange Programs in Kentucky

Facts about Syringe Exchange Programs

  • SEPs do not encourage the initiation of drug use nor do they increase the frequency of drug use among current users. (1)
  • SEPs reduce the spread of infections like HIV and viral hepatitis. (2)
  • SEPs do not increase community crime. Community residents may worry that syringe exchange locations will increase theft, sex trades, assaults, and an increase of contaminated needles on the street. However, studies have shown that syringe exchange programs actually decrease crime in the area they are located. (3)
  • SEPs increase community safety. Research shows that SEPs promote public health and safety by taking syringes off the streets and protecting law enforcement personnel from needle stick injuries, which can result in the transmission of diseases such as HIV/AIDS and hepatitis B and C. (4)
  • SEPs connect people to treatment. One study found that SEP participants are five times more likely to enter a drug treatment program than nonparticipants. (5)


Recommended Best Practices for Effective Syringe Exchange Programs in the United States

Syringe exchange programs are central to reducing disease and other health burdens among people who inject illicit drugs. Three decades of research have demonstrated the effectiveness of SEPs in preventing HIV and other blood-borne infections, as well as connecting people who inject drugs (PWIDs) with a range of vital medical and social services and supports. The Recommended Best Practices report from the New York City Department of Health and Mental Hygiene with the Drug Policy Alliance summarizes the consensus among United States SEP experts of the underlying principles and programmatic elements that enable or constrain SEP effectiveness. Effective SEPs have the support of local governing bodies and match sound operational characteristics with responsiveness to the unique features of their host communities. New or expanding SEPs may benefit from technical assistance from the considerable expertise of those experienced in operating SEPs around the country. The panel highlighted operational characteristics that are critical for effective SEPs, and measures to be avoided because they undermine the primary goal of SEP: to make new, sterile syringes available to PWIDs.

Characteristics of Effective SEPs (6)

  • Ensure low threshold access to services
    • Maximize access by number of locations and available hours
    • Ensure anonymity of participants
    • Minimize the administrative burden of participation
  • Promote secondary syringe distribution
    • Train and support peer educators
    • Do not impose limits on number of syringes (doing so promotes sharing of needles)
  • Maximize responsiveness to characteristics of the local PWID population
    • Adapt planning activities and service modalities to subgroup needs
  • Provide or coordinate the provision of other health and social services
  • Include diverse community stakeholders in creating a social and legal environment supportive of SEPs

SEP Practices to avoid 6

  • Supplying single-use syringes
  • Limiting frequency of visits and number of syringes
  • Requiring one-for-one exchange (results in sharing of needles)
  • Imposing geographic limits
  • Restricting syringe volume with unnecessary maximums
  • Requiring identifying documents
  • Requiring unnecessary data collection
Hours and Locations of Syringe Exchange Programs
Syringe Exchange Programs in Kentucky Learn more about Syringe Exchange Programs in the box above.  
City Address MO TU WE TH FR SA
Ashland The Neighborhood, 2516 Carter Avenue - - - - 11-2 -
Barbourville Knox County Health Department, 261 Hospital Dr. - - - 1-3 - -
Bowling Green Barren River District Health Department, 1109 State Street - - - 12-4 - -
Cynthiana Harrison County Health Center, 364 Oddville Ave. - - - 12-4:30 - -
Danville Boyle County Health Center (basement), 448 S 3rd Street - - - - 1-3 -
Falmouth Pendleton County Health Center, 329 KY-330 1-3 - - - - -
Frankfort Franklin County Health Department, 100 Glenns Creek Road 8-4:30 8-4:30 8-4:30 8-4:30

8-4:30

-
Grayson Courthouse, 300 West Main Street 8-3 8-3 8-3 8-3 8-3 -
Harrodsburg Mercer County Health Department, 900 N. College Street 8-4:30 8-6 8-4:30 8-6

8-12:30

-
Lancaster Garrard County Health Department, 89 Farra Drive 8-4:30 8-6 8-4:30 8-4:30 8-12 -
Lexington Lexington-Fayette County Health Department, Dr. Rice C. Leach Community Room, 650 Newtown Pike - - - - 11 - 4:30 -
Louisville Louisville Metro Public Health & Wellness, 400 E. Gray St. 11-4 1-6 1-6 3-6 11-4 11-2
Louisville Lake Dreamland Fire Station, 4603 Cane Run Rd - - - 11-2 - -
Louisville 1455 Bicknell Ave. (corner of Bicknell and Taylor) - - 11-2 - - -
Louisville Redeemer Lutheran Church, 3640 River Park Drive - 9-12 - - - -
Manchester Clay County Health Department, 330 Shamrock Road - - - -

12:30-3:30

-
Maysville Mason County Health Department, 130 East Second Street - 2-4 - - - -
McKee Jackson County Health Department, 456 Main Street South - - - - 12-3:30 -
Morehead Rowan County Health Department, 730 West Main Street - 2-4 - - - -
Nicholasville Jessamine County Health Department, 210 East Walnut St. 3-6 - - - - -
Pikeville Pike County Health Department, 119 River Drive 4:30-5 - - - - -
Prestonsburg Floyd County Health Department, 283 Goble Street - - 3-6 - - -
Stanton Powell County Health Department, 376 North Main Street - - - 5:30-7 - -
Williamsburg Whitley County Health Department, 368 Penny Lane - - - - 2-4 -
Williamstown Grant County Health Center, 234 Barnes Road - - 1-4 - - -
Winchester Clark County Health Department, 400 Professional Avenue - - - - 12-4 -
Naloxone (Narcan) Availability

Naloxone Availability in Kentucky

Naloxone (Narcan®) is a prescription medication that can reverse an overdose that is caused by an opioid drug. When administered during an overdose, naloxone blocks the effects of opioids on the brain and restores breathing. It can be given as an injection into a muscle or as a nasal spray.

Find out where to get Naloxone in Kentucky

Condom Distribution

The Kentucky Department for Public Health contracts with several agencies to provide condom distribution:

AVOL (AIDS Volunteers, Inc.)
365 Waller Ave., Suite 100
Lexington, KY 40504
859-225-3000

Lexington-Fayette County Health Department
650 Newtown Pike
Lexington, KY 40508
859-288-2437

Louisville Metro Public Health and Wellness
7201 Outer Loop
Louisville, KY 40228
502-574-6699

Northern Kentucky Independent District Health Department
2388 Grandview Drive, Building A
Fort Mitchell, KY 41047
859-578-7660

Volunteers of America Mid-States
1436 South Shelby Street
Louisville, KY 40217
502-635-4511

Agency Training on HIV Testing

Kentucky law requires HIV test counselors to be trained in the Fundamentals of HIV Prevention Counseling. Space is limited in these full-day workshops. To participate, follow these steps:

  1. Complete this survey to advise us that you need training.
  2. Create an account on KY.TRAIN.org if you don't already have one.
  3. Take the online prerequisite course #1021131 on KY.TRAIN (3.6 hours) (general information on HIV).
  4. Take the online prerequisite course #1054132 on KY.TRAIN (3.0 hours) (preparatory courses on HIV counseling).
  5. Take the online prerequisite courses #1052459 and #1052460 (courses on rapid HIV testing)
  6. Find a workshop in your area and register.

Training on the use of rapid HIV tests involves taking the appropriate KY.TRAIN module listed below. These modules require that you successfully run a set of rapid test kit controls in the presence of your testing supervisor. Ask which type of rapid test your agency is using to determine which module you will need.

Rapid-Rapid HIV Testing Protocol

Nonclinical Kentucky HIV test sites can now test all clients with rapid HIV antibody tests. Those with negative tests are considered as antibody-negative and no additional antibody testing would be required at that time. Those with reactive results from the rapid test can be tested immediately with an additional brand of rapid test that is less sensitive than the initial rapid test. Clients receiving reactive results from both rapid tests are almost certainly infected with HIV and can be promptly linked to an HIV care provider without waiting days or weeks for a confirmatory test.

This testing approach is for nonclinical settings such as harm reduction/syringe exchange programs, community-based organizations, outreach testing efforts, and field testing. This algorithm has not been approved for use in clinical settings.

Download Kentucky Public Health publication Implementing Rapid-Rapid HIV Testing in Nonclinical Settings

 

Last Updated 5/3/2017