UPDATE 9/24/19 @ 12:04 p.m.

The number of confirmed HIV cases in Cabell County continues to rise.

As of Sept. 23, there are now 80 cases in the county. Health officials say the cluster is happening among IV drug users.

Critics have questioned whether there's a connection between the rising HIV numbers and the health department's needle exchange program. Dr. Michael Kilkenny says there is no connection. The increase in HIV numbers sparked a call for an audit of the needle exchange program, which was denied.

Health officials say it's an unprecedented cluster. The number of cases in Cabell County just this year is more than the entire state of West Virginia since 2008.

UPDATE 9/3/19 @ 10:30 p.m.

A public forum was held Tuesday evening on the growing HIV cluster in Cabell County.

There have been 76 confirmed cases of HIV in a cluster in Cabell County. That's more in Cabell County in a single year than in the entire state of West Virginia since 2008.

"This is a cluster of HIV cases like has never happened before in the state of West Virginia," Dr. Michael Kilkenny said.

Kilkenny says they expect the number of cases to go up, but they are seeing fewer than earlier in the year.

"We don't just want to control this cluster, we want to stop the transmission of HIV in Cabell County," he said.

Kilkenny says they've increased testing, and the health department is offering a one-pill-a-day protection for those at high risk that can strongly reduce the risk of getting HIV.

Critics have questioned whether there's a connection between the rising HIV numbers and the health department's needle exchange program.

Kilkenny says there is no connection.

"The harm reduction program exists to keep the increase down," he said. "They are opposing forces. We are not the cause of this. We are once piece of the solution."

Dr. Kara Willenburg with the Marshall School of Medicine says the harm reduction program helps those affected get connected with the resources needed to get better.

"We do have success stories of patients out of this cluster who now have jobs and are being productive members of the community," she said. "We can do it."

As to why the HIV numbers have risen so high in Cabell County, Kilkenny says they don't know.

He described this as a natural disaster and said events like this don't care what people put in place to stop them.

Kilkenny says since the needle exchange program began, they've been getting fewer complaints about people finding needles in public, and they're having more needles brought in than given out.

They're having another forum on the HIV issue next Tuesday at Christ Temple Church from 6 to 8 p.m.

The increase in HIV numbers sparked a call for an audit of the needle exchange program, which was denied.

UPDATE 8/20/19 @ 6 p.m.

West Virginia Gov. Jim Justice is responding to a request from two state and local leaders for an audit of the Cabell-Huntington Health Department's harm reduction program, or needle exchange program.

Kelli Sobonya, a Cabell County commissioner, called for an audit of the Cabell-Huntington Health Department's harm reduction program, asking the Department of Health and Human Resources to take a look at the program in light of the growing HIV cluster.

At the beginning of August, the DHHR ultimately decided not to move forward with the audit, saying "the focus of program audits is typically on fiscal accountability and quality improvement" and would "be of little benefit in addressing the concerns expressed."

Now, Sobonya, and Delegate John Mandt. Jr. are calling on Justice to intervene and require the audit.

WSAZ asked the governor at a news conference Tuesday about his plans and if he would have the state move forward with an audit. However, his answer wasn't a yes or no.

"Probably," he said. "Probably so. It's a little premature right yet. But probably so. We have made great strides in the HIV issues, but we don't want to start slipping backwards."

Both Sobonya and Mandt say they have questions about the program and feel an audit would answer questions about the county's needle exchange program, which is designed to help stop the spread of diseases like HIV.

"We don't want to have those numbers rising in our county," Sobonya said. "I think that an audit is the best way to get questions answered."

The governor during that news conference told WSAZ he doesn't want people to jump to conclusions about the program.

"Cabell County has made so many phenomenal strides," he said. "I mean, if you just look at the overdose numbers and everything of what we have done with opioids in Cabell County, it's amazing. So we don't need to beat up on them prematurely."

Keep checking WSAZ.com and the WSAZ App to see if the governor decides to move forward with the audit.

A public forum has been scheduled to talk about several topics including the county's needle exchange program. That is set at 6 p.m. Sept. 10 at Christ Temple Church in Huntington.

UPDATE 8/19/19 @ 7 p.m.

As the number of HIV cases climbs in Cabell County, local and state leaders are calling for a closer look at the county's harm reduction program, or needle exchange program.

Kelli Sobonya, a Cabell County commissioner, called for an audit of the Cabell-Huntington Health Department's harm reduction program in June, asking the Department of Health and Human Resources to take a look at the program in light of the growing HIV cluster.

Her concerns followed news of an active HIV cluster in Cabell County that health officials say is happening among IV drug users.

"There are some underlying questions I think haven't been answered," Sobonya said. "So I requested an audit on behalf of my constituents."

When she first called for the audit, there were 53 confirmed cases. On Monday afternoon, that number had gone up to 73, up two cases from the previous week.

"We want to know is it working," Sobonya said. "When you have several harm reduction programs in the state and your program in your county is dealing with the only known HIV cluster in the state. When you have more HIV cases in your county, more than all of the other counties combined, that shows there is a structural problem within this program. We just want answers."

At the beginning of August, the DHHR ultimately decided not to move forward with the audit, saying "the focus of program audits is typically on fiscal accountability and quality improvement" and would "be of little benefit in addressing the concerns expressed."

"I just think that information is power," Sobonya said. "If an audit was performed on Kanawha County's program, and they say it was done after it was closed down, why can't we receive the same type of audit?"

Sobonya is referring to a similar needle exchange program in Kanawha County, which ultimately was shut down in 2018.

The program was shut down after WSAZ launched an investigation, sparked by concerns from first responders and public health officials about the amount of needles in and around public places.

An audit, later conducted by the DHHR, found several issues with the program including "data errors leading to misinformation to the public" and "an increase of syringe litter viewed as a threat to public safety."

WSAZ reached out to the DHHR about why this type of audit wouldn't be as beneficial in Cabell County. On Monday, WSAZ received a statement from the DHHR, saying the state can't conduct an audit due to the request centering around restrictive residency requirements, citing a policy put in place in 2018 in the county requiring all program participants to live in the county.

However, Sobonya's original request asked the state to take a look at the program in light of the growing HIV cluster.

Both she and Delegate John Mandt Jr. are still asking that the audit be performed.

"I think we need an audit and we need questions answered," Mandt said. "Where are these HIV cases coming from? Did they happen here or did they migrate into Huntington? Transparency is real important. Let's get some answers, go from there, and get this program to work like it should, if we need to continue the program."

Dr. Michael Kilkenny, director of the Cabell-Huntington Health Department, says the county's needle exchange program is helping stop the spread of disease and says he will comply with the state's decision when it comes to an audit.

"I've heard different criticisms," Dr. Kilkenny said. "I've even heard people say that the harm reduction program is causing this. Harm reduction programs don't cause HIV outbreaks anymore than seat belts cause crashes. There are still disease outbreaks and there are still car crashes. The harm reduction program's role is to reduce the number of cases, to reduce the risk for people, to prevent the case if we can and to improve the status for everybody in the community."

According to a statement from the DHHR, "Beyond prevention, it is important to note, especially with rising numbers of cases, that Harm Reduction Program Services are one of the most critical and essential tools for addressing HIV clusters. Unnecessary disruption of the same would put Cabell County citizens at increased risk of disease and decrease the number of individuals linked to recovery services through these programs."

Sobonya and Mandt have called on West Virginia Gov. Jim Justice's office to intervene and require an audit of the program.

"I like to do my due diligence and do my research," Sobonya said. "Find out what works, what doesn't work. But I think with a controversial program like this, I think it is very important to have the community's support."

WSAZ reached out to the governor's office to see if he is going to step in. WSAZ has not heard back, but we will keep trying.

A public forum has been scheduled to talk about several topics including the county's needle exchange program. That is set at 6 p.m. Sept. 10 at Christ Temple Church in Huntington.

UPDATE 8/13/19 @ 7:10 p.m.

Cabell County's HIV cluster is still growing in numbers, now up to 71 confirmed cases.

Health officials at the Cabell-Huntington Health Department say the spread of the disease will "decline before we see the case count stabilize."

Officials say a jump in the case count doesn't necessarily mean the disease is spreading fast.

However, they say everyone should be concerned about the cluster.

At the end of June, the number of confirmed cases of HIV in the county was at 53. As of, August 12, that number was 71.

The cluster has been tracked since January 2018.

The West Virginia Department of Health and Human Resources launched a website at the beginning of August to update the number of cases each week. That website can be found

.

The DHHR confirmed that one person died from the virus in June.

Health officials say the cases confirmed so far have been linked to IV drug users in Cabell County that are sharing used needles.

According to the DHHR, the best ways to stop the case numbers from going up is "increased testing, enhanced surveillance, and expanded outreach help identify those who are positive and link them to care" and "harm reduction programs."

However, Cabell County's harm reduction program has been at the center of controversy. In June, Cabell County Commissioner Kelli Sobonya requested a public audit of the program.

In a meeting with DHHR officials, state representatives and county commissioners, it was decided that an audit of the program would not happen.

The Cabell-Huntington Health Department says the department did not participate in that discussion, but that they comply and cooperate with the decisions of the DHHR.

WSAZ requested an interview with the health department's director Tuesday after the new HIV numbers were released. We were told no one was available for an interview, but we were given a statement.

In a statement to WSAZ, the Cabell-Huntington Health Department's Director said their main priority is "to stop the spread of HIV in our community. We are dedicating our resources to stopping the spread of HIV."

UPDATE 8/13/19 @ 10:05 a.m.

West Virginia health officials say the number of HIV cases in Cabell County has risen to 71.

The cluster has been tracked since January 2018.

Officials still define the situation as a cluster rather than a full outbreak. The West Virginia Bureau for Public Health characterizes a cluster as being confined to a certain population -- in this case, IV drug users -- where it may be able to be controlled with minimal risk to the general public.

"Since January 2018, Cabell County has experienced an increase in the number of HIV cases, primarily among people who inject drugs," the West Virginia Department of Health and Human Resources' website states. "Public health officials are working to identify gaps in prevention and care services and directing resources to ensure that these services reach the populations that need them most, which in turn saves health care dollars associated with HIV and other related health outcomes."

The number of cases is is updated every week. There are 71 cases in the county as of Aug. 12.

UPDATE 7/1/19 @ 9:45 p.m.

A death has been linked to the HIV cluster in Cabell County, the Cabell-Huntington Health Department said Monday.

"We are not releasing any identifiable information, simply confirming the death," a health department spokeswoman said.

Late last month, health officials say the number of HIV cases in Cabell County had risen to 53. They also said the cluster had spread mainly among intravenous drug users and is not a threat to the general public.

Tracked since January 2018, the cluster represents a sharp uptick from the baseline average of eight cases annually over five years. Cabell County's is currently the only active HIV cluster in West Virginia.

UPDATE 6/22/19 @ 3:15 p.m.

West Virginia health officials say the number of HIV cases in Cabell County has risen to 53.

News outlets report the total increased by four cases in the past four weeks and nine cases in the past nine weeks.

The cluster has spread primarily among intravenous drug users.

The cluster, tracked since January 2018, represents a sharp uptick from the baseline average of eight cases annually over five years. Cabell County's is currently the only active HIV cluster in West Virginia.

The situation is still defined as a cluster rather than a full outbreak. The West Virginia Bureau for Public Health characterizes a cluster as being confined to a certain population -- in this case, IV drug users -- where it may be able to be controlled with minimal risk to the general public.

UPDATE 5/27/19 @ 10:30 p.m.

West Virginia health officials say an HIV cluster in Cabell County reflects a shift in how the disease is being transmitted.

According to Cabell County Health Department officials, the county's cluster -- the only one currently known in West Virginia -- is up to 49 confirmed cases.

State officials say all the cases were contracted by intravenous drug use through sharing of contaminated syringes.

The cluster, tracked since January 2018, represents a sharp uptick from the baseline average of eight cases annually over the past five years.

In 2017, West Virginia had one of the nation's lowest rates of HIV diagnoses (4.3 cases per 100,000 residents), according to the Centers for Disease Control and Prevention. Kentucky (7.9 per 100,000) fared similarly.

The HIV cluster could potentially be devastating for communities ravaged by opioid addiction.

UPDATE 4/30/19 @ 6:30 p.m.

HIV cases are still climbing in Cabell County.

In March, there were 28 cases. As of April 22, that number had gone up to 44 cases.

"Right now we are still identifying new cases, so our case count is going up," said Dr. Michael Kilenny, director of the Cabell-Huntington Health Department.

The cases are considered to just be a cluster and not an outbreak since it is confined to a certain group of people.

A majority of the cases have been confirmed in injection drug users.

To help try to keep cases from spreading, health officials are urging anyone who is at risk to get anti-viral medications. The Cabell-Huntington Health Department is working to prescribe those to people at risk, not people who have already been diagnosed.

"We are working really closely with the West Virginia Bureau for Public Health and the CDC to put strong effective control measures on this cluster and we can hopefully not only stop it from spreading in the community at risk, but ease any fears of the general public," Kilkenny said.

Right now, the cluster confirmed in Cabell County is the only one confirmed in the state. However, state health officials are urging providers across the state to increase HIV testing.

According to the West Virginia Bureau of Public Health, sexual contact was the main risk factor for contracting HIV before 2018. However, that year the main risk factor shifted to injection drug use.

Health officials say they will likely see more cases of HIV confirmed until their intervention efforts begin to take effect.

The Cabell-Huntington Health Department offers a needle-exchange program, called the harm reduction program. It offers users clean needles and health officials say it helps to prevent the spread of different diseases. Officials say needle sharing among drug users has been a big contributing factor to the spread of HIV.

"This is coming from sharing syringes and that's another issue," Dr. Kilkenny said. "The availability of sterile syringes for people injecting drugs is more important than ever."

There are an estimated 1,800 injection drug users in Cabell County.

Officials say the goal now is to quickly link those who have been affected with the virus with care, and to get those who are most at risk anti-viral medications.

ORIGINAL STORY 3/5/19

West Virginia heath officials say an active HIV cluster has been confirmed in Cabell County.

A statement from the West Virginia Department of Public Health says there are 28 known cases, primarily among intravenous drug users.

Officials told The Herald-Dispatch the cluster represents a sharp increase from the baseline average of eight cases annually over the past five years.

Cabell-Huntington Health Department physician director Michael Kilkenny says it is the first notable HIV cluster in West Virginia where intravenous drug use is identified as the main risk factor.

Although the cases are confined, Kilkenny says officials estimate that Cabell County has more than 1,800 active IV drug users, so introducing HIV into that population is very concerning.