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.

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Discussion: Intermittent and daily light smokers differ on several tobacco-related and psychosocial variables. Attending to these factors in prevention and cessation programs may enhance abstinence in both groups. IntroductionSmoking is the leading cause of preventable death in the United States ( Centers for Disease Control and Prevention, 2004 ). Despite a decrease in smoking among middle-aged and older adults, young adult smoking prevalence declines are smaller, and reductions in moderate to heavy smoking have been accompanied by an increase in prevalence of light and intermittent smoking ( Pierce, White, & Messer, 2009 ). One group of young adults who demonstrate high rates of smoking are individuals serving in the military ( Bray et al., 2006 ;Nelson & Pederson, 2008 ).Two subgroups of smokers who have received growing attention ( Fiore et al., 2008 ) and have yet to be examined among military personnel are light and intermittent (i.e., nondaily) smokers. Both young adults ( Substance Abuse and Mental Health Services Agency, 2004 ) and ethnic minorities ( Ahluwalia et al., 2006 ;Rodriguez-Esquivel, Cooper, Blow, & Resor, 2009 ;Trinidad et al., 2009 ) are predominant in the military and evidence high rates of low-level smoking. Therefore, light and intermittent smoking are likely to be especially common in this group.A pattern of maintaining low levels of smoking has multiple implications. First, relative to never smoking, even light smoking is deleterious to health such that light smokers are at increased Abstract Introduction: Few studies have assessed differences between intermittent and light smokers, particularly among young adults. Exploring these differences promotes a systematic approach to research and treatment in low-level smokers. This study explored demographic, tobacco-related, and psychosocial predictors of intermittent nondaily smoking relative to light smoking among basic military training (BMT) recruits. The impact of smoking status on abstinence rates at follow-up was also assessed.Methods: Participants were 5,603 U.S. Air Force BMT intermittent nondaily ( n = 3,134) or light daily ( n = 2,469) smoking recruits participating in a population-based group randomized trial targeting tobacco use prevention and cessation , Effi cacy of a tailored tobacco control program on long-term use in a population of U.S. military troops. Journal of Consulting and Clinical Psychology , 74,[295][296][297][298][299][300][301][302][303][304][305][306]. Participants completed baseline measures assessing demographics; tobacco use and history; and common social, attitudinal, and behavioral risk factors for tobacco use. Flights of recruits were randomly assigned to a tobacco use intervention or health education control intervention. At the 1-year follow-up, participants reported 7-day point prevalence and continuous abstinence. Results:Intermittent nondaily smoking relative to light daily smoking was associated with lesser perceived addiction, intermittent and daily use of smokeless tobacco, nonsmoking male and fe...