"We know that historically, we have not had a lot of transmission," said Kim Toevs, the Communicable Disease and STD Program director at the Multnomah County Health Department during a press conference on Thursday. "Transmission through syringes, and sharing syringes, scares us because it's the most effective way to transmit HIV, unfortunately. It's easier to transmit HIV through sharing a syringe than through sexual activity, so we are concerned that it could rapidly spread locally."