ABSTRACT
OBJECTIVE: To examine suicide deaths among working-age residents in Massachusetts and to determine industries and occupations with high numbers and rates of suicides. METHODS: The Massachusetts Violent Death Reporting System and Massachusetts death certificates were used to analyze suicide deaths from 2016 to 2019. Counts and rates were generated by demographics and industry and occupation groupings. RESULTS: There were 2199 working-age Massachusetts residents who died by suicide. Higher suicide rates were associated with being male, 65 years or older, White, and non-Hispanic or having military background. Suicide rates were higher among the construction industry sector and the construction and extraction occupational group compared with the average rate for all Massachusetts workers. CONCLUSIONS: Suicide rates differed between industries and occupations, suggesting that work-related factors may play a role and should be considered when planning outreach initiatives and interventions.
Subject(s)
Construction Industry , Military Personnel , Suicide , Humans , Male , Female , Massachusetts/epidemiology , OccupationsABSTRACT
BACKGROUND: The Massachusetts Department of Public Health and the Centers for Disease Control and Prevention collaborated to characterize a human immunodeficiency virus (HIV) outbreak in northeastern Massachusetts and prevent further transmission. We determined the contributions of HIV sequence data to defining the outbreak. METHODS: Human immunodeficiency virus surveillance and partner services data were analyzed to understand social and molecular links within the outbreak. Cases were defined as HIV infections diagnosed during 2015-2018 among people who inject drugs with connections to northeastern Massachusetts or HIV infections among other persons named as partners of a case or whose HIV polymerase sequence linked to another case, regardless of diagnosis date or geography. RESULTS: Of 184 cases, 65 (35%) were first identified as part of the outbreak through molecular analysis. Twenty-nine cases outside of northeastern Massachusetts were molecularly linked to the outbreak. Large molecular clusters (75, 28, and 11 persons) were identified. Among 161 named partners, 106 had HIV; of those, 40 (38%) diagnoses occurred through partner services. CONCLUSIONS: Human immunodeficiency virus sequence data increased the case count by 55% and expanded the geographic scope of the outbreak. Human immunodeficiency virus sequence and partner services data each identified cases that the other method would not have, maximizing prevention and care opportunities for HIV-infected persons and their partners.
Subject(s)
Contact Tracing/methods , Disease Outbreaks/prevention & control , HIV Infections/epidemiology , HIV-1/genetics , Substance Abuse, Intravenous/complications , Adolescent , Adult , Contact Tracing/statistics & numerical data , Disease Outbreaks/statistics & numerical data , Drug Users/statistics & numerical data , Epidemiological Monitoring , Female , HIV Infections/prevention & control , HIV Infections/transmission , HIV Infections/virology , HIV-1/isolation & purification , Humans , Male , Massachusetts/epidemiology , Middle Aged , RNA, Viral/genetics , RNA, Viral/isolation & purification , Sequence Analysis, RNA , Substance Abuse, Intravenous/epidemiology , Young Adult , pol Gene Products, Human Immunodeficiency Virus/genetics , pol Gene Products, Human Immunodeficiency Virus/isolation & purificationABSTRACT
Objectives. To describe and control an outbreak of HIV infection among people who inject drugs (PWID).Methods. The investigation included people diagnosed with HIV infection during 2015 to 2018 linked to 2 cities in northeastern Massachusetts epidemiologically or through molecular analysis. Field activities included qualitative interviews regarding service availability and HIV risk behaviors.Results. We identified 129 people meeting the case definition; 116 (90%) reported injection drug use. Molecular surveillance added 36 cases to the outbreak not otherwise linked. The 2 largest molecular groups contained 56 and 23 cases. Most interviewed PWID were homeless. Control measures, including enhanced field epidemiology, syringe services programming, and community outreach, resulted in a significant decline in new HIV diagnoses.Conclusions. We illustrate difficulties with identification and characterization of an outbreak of HIV infection among a population of PWID and the value of an intensive response.Public Health Implications. Responding to and preventing outbreaks requires ongoing surveillance, with timely detection of increases in HIV diagnoses, community partnerships, and coordinated services, all critical to achieving the goal of the national Ending the HIV Epidemic initiative.
