Good morning. Welcome to Axios today. It's Friday, August 6th. I'm Nyla Boudou. Here's

what you need to know today. Fightin' gets tough with GOP governors on COVID. Plus,

lap-grown salmon coming to a sushi bar near you. But first, today's one big thing. How

the opioid crisis is fueling HIV outbreaks in West Virginia and beyond.

One of our listeners in West Virginia, Lucas from Charleston, texted me recently about a local

outbreak of HIV in his town. Earlier this year, the CDC called this outbreak in Kanah County,

West Virginia, the most concerning HIV outbreak in the entire US associated with injection drug use.

This week, the CDC issued a report on how to manage this outbreak, but their recommendations are

almost impossible to implement because of current local laws. Lucas suggested we speak with

Mountain State Spotlight's public health reporter, Lauren Pease, who's been covering what's been

happening in West Virginia. So we call her out. Hi, Lauren. Hi, thanks so much for having me.

So what is the CDC recommending in their report that they put out this week? They were called into

town earlier this summer to address the outbreak in Charleston in West Virginia's capital city,

where 72 new cases of HIV linked to injection drug use have been identified to put that in

perspective, a city of Charleston size and a county the size of Kanah in a typical year in the US

would have fewer than one new cases of HIV linked to injection drug use. One of the number one

recommendations that came in this report was to increase access to sterile needles for people

who inject drugs, but because of the legislation that was passed, that's not currently an option.

Lauren, can you tell us when this HIV outbreak first started? So it's actually kind of the result

of a closure of a harm reduction program, which offered clean needle services or syringe access

services to people who inject drugs between 2015 and 2018. So the harm reduction program run by the

health department in Charleston became highly politicized during a race for city mayor in 2018.

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