When public health officials say that the HIV outbreak in Scott County could have happened anywhere in Indiana, they do mean almost everywhere.
The human immunodeficiency virus outbreak in southeastern Indiana had reached 135 cases as of Tuesday, and officials say increased testing will find even more HIV-positive Hoosiers. New HIV cases also have been traced to neighboring Jackson County, although the Indiana State Department of Health said those cases are contained to that area.
On March 26, Gov. Mike Pence declared a public health state of emergency, which he extended this week through the end of May. Pence’s executive order also extends the temporary needle exchange program through which Scott County residents can safely dispose of used needles and receive clean needles as a method of harm reduction. The HIV cases in southeastern Indiana are linked directly to illegal injection drug use of Opana, an opioid used much like heroin.
“We know people are sharing needles. They’re getting hep C (hepatitis C). That’s how you get hep C. We’re a little surprised we haven’t seen more HIV transmitted that way,” said Jill Stowers, clinical lead manager of community health at Indiana University Health Bloomington. “It’s proving what we have suspected — that at any moment in the right situation, there could be huge outbreak related to injected drug use.”
As of Tuesday, 95 people had exchanged 3,111 used needles for 4,337 clean needles, according to the State Department of Health. But outside of Scott County, there is nowhere drug addicts can go to turn in their used and reused needles for clean syringes. It’s against state law.
Indiana code prohibits the possession of a hypodermic syringe or needle to use an illegal drug by injection, as well as the delivery of items used to inject controlled substances. Pence’s executive order suspends these laws in Scott County during the state of emergency. But dozens of Indiana counties are at risk of increasing rates of HIV and could benefit from an expanded needle exchange program, according to data from Indiana University’s Rural Center for AIDS/STD Prevention.
HIV is the virus that causes acquired immune deficiency syndrome, or AIDS.
“What we know is that they are a tremendous strategy to reduce hepatitis C and HIV in drug-using populations that access these programs,” said Beth Meyerson, an assistant professor of applied health science at IU and co-director of the Rural Center for AIDS/STD Prevention.
The needle exchange programs that prove most effective are community-led and couple needle exchange with HIV testing and HIV and substance abuse treatment, Meyerson said. The Scott County needle exchange is located in a “one-stop shop” at the Austin Community Outreach Center, where free HIV testing, care coordination and substance abuse referrals also take place.