Austin, the epicenter of Indiana's HIV outbreak

Boarded up windows mark nearby houses. Metal cages surround air conditioners to bar people from stealing parts to scrap for change. Austin has grocery store, much less a rehabilitation facility, much less a 

It’s also the epicenter of the worst HIV outbreak in Indiana history.

While state and federal health officials are flocking to Scott County in response to staggeringly high rates of recent HIV cases, the outbreak is no surprise to local residents.

“We have kind of a recipe for disaster, all the bad ingredients — unemployment, high drop out, high teen pregnancy rate, high drug abuse rate,” said Dr. William Cooke, medical director for Family Foundations Medicine in Austin, a town of 4,000 in a county of 24,000.

Health officials have confirmed 55 cases of HIV in Scott County since December. Cooke, along with others, is advocating for more resources in handling the outbreak that is soon expected to reach triple digits.

But he’s also advocating for preventive measures, specifically a behavioral health addiction clinic, to stave off drug abuse that he said is 100 percent responsible for the current HIV outbreak. Discarded syringes lie on the side of the road in Austin — evidence of the addiction that grips the city.

“I work in the emergency department down here as well, and I see it every shift — somebody comes in, overdosed on drugs,” Cooke said. “You save them, you ask them why they do it, they say they don’t want to. ... Nobody in middle school had the plan to be an [intravenous] drug user when they grew up. It’s something that happens. Even the IV drug users don’t want to be the IV drug users.”

An immediate response

Amy Reel, director of the office of public affairs for the Indiana State Department of Health, said some CDC officials will stay for a week and a half.

They’ll be analyzing data to determine whether the virus is new or if it’s a strain that has been circulating for a while.

“And they’re also going to be looking at HIV treatment and substance abuse systems, so helping us ensure that we have those systems in place so that we can get them into the care that we need,” Reel said.

CDC officials will be reaching out to those who have tested positive and offering continued care.

The Clark County Health Department — the only department in nine contiguous counties in Southeastern Indiana that receives state funding for HIV testing — and the state health department have been administering free HIV testing from the Family Foundations Medicine and in the Scott County Health Department offices.

But mostly, officials have been making home visits.

“They call their friends and family and they come over to get tested as well,” he said. “They usually bring five to 10 extra kits with them to each home because they know that once they get there, there’s going to be others that will come over.”

Cooke said no one in his office is qualified for free testing, though nurses are being trained by the state health department this week.

“My goal is to have availability to testing for anybody that walks into the door at any time,” he said.

Dr. Janet Arno, an infectious disease specialist at IU Health University Hospital, is opening a clinic next week at Family Foundations for ongoing care with HIV-positive patients, “long after the CDC leaves,” Cooke said.

Cooke is scheduled to speak today at an Indiana House of Representatives Public Health Committee hearing on the HIV outbreak and a proposal to allow Scott County officials to launch an emergency needle-exchange program to stem the spread of the virus.

State Rep. Terry Goodin, D-Austin, said he supports that method of preventing proliferation of the disease.

“What I’m going to support is what the professionals say is going to work,” Goodin said.

Goodin asked Gov. Mike Pence’s office for more resources in Scott County for testing and treatment, but he hasn’t heard back.

Cooke is also petitioning the state health commissioner and the Indiana Family and Social Services Administration to open an addiction treatment center in Scott County.

Treatment facilities are in other counties, and many Scott County residents lack transportation.

“How do you get in touch with a program on a regular basis [out of the county]?” Cooke said. “So we need to bring it here.”

An overwhelming issue

Cooke was born in New Albany and grew up in Jeffersonville, but he located in Austin specifically because of its lack of resources.

He said more than half of Scott County deaths are due to IV drug overdose.

“The scary part of using IV drugs is not going to keep people from using IV drugs,” Cooke said. “They need help ...”

Debbie and Jerry Ousley founded Oasis of Hope Missions that provides meals every two weeks to those in need. Some are those with substance-abuse issues, which she’s seen escalate year after year.

“We worked down here for the least year-and-a-half to two years,” Ousley said. “It’s just nothing new to us.”

Austin has a particularly high number of prostitutes, almost all who are driven by a means to pay for their drug addictions.

Debbie said most are in their early 20s. She sees cars circle around the same neighborhood looking for them.

“We have a whole new outlook on this ... because when we see the girls on the street, getting picked up, it breaks our heart because we know that it’s all about drugs,” she said.

Jerry said that because there are no drug rehabilitation programs nearby, many prostitutes return to their addictions after being released from jail for lack of help.

“If you talk to any girls, they do not want to do what they’re doing,” he said.

However, many Austin residents have a different opinion of the issue — quick to blame prostitution despite drug use being the cause of the outbreak.

Richard Barrett, who lives in Jefferson County but has family in Scott County, said Austin has a bad reputation.

“Back in the day it used to be racism, then it went to drugs, then poverty, now it’s been hit with the HIV outbreak,” Barrett said. “A lot of things go hand in hand, in my opinion.”

Enough enforcement?

Austin City Council president Jim Kallembach said the city has had plenty of drug problems that it hasn’t been able to fix.

“We should have had a handle on a lot of this stuff for a long time,” Kallembach said. “We’ve let this community run wild.”

He blamed Mayor Douglas Campbell’s administration for not pushing the police force enough to bust drug dealers.

“When there’s a drug house on every corner, someone ought to be getting arrested,” he said. “I mean, it’s pretty simple. And everybody knows what’s going on.”

Lately, the Indiana State Police has been making arrests — as many as 100, he said.

He said the drug abuse problem saturates “the whole town” and is “overwhelming.”

“The CDC hasn’t even got a clue [how bad the problem is],” Kallembach said. “They can’t even imagine.”

Austin Police Chief Donald Spicer said a lack of resources means fewer drug arrests. The department has seven paid officers, including the chief, and about 15 volunteers.

“Drugs is a problem that’s hard to contain,” he said. “When you find one home, it spawns two or three more. It snowballs.”

Spicer doesn’t agree with Kallembach’s “negative” outlook on the issue and insists his department is doing everything it can in making drug-related arrests.

“Yes, there’s drug dealers on every corner, but so is there in Louisville and so is there in Indianapolis or any other city,” he said.

An officer needs probable cause to arrest someone.

“Yes, we know so and so is dealing drugs, but that doesn’t give me the legal authority to go in arrest them,” Spicer said. “I have to be able to prove it ... so we protect your rights, we have to protect the drug dealer’s rights. We take an oath to follow the rules.”

He said he’s been communicating with the ISP, Scott County Sheriff’s Department and Scottsburg Police Department to turn his department “into 20 or 25 by working together.”

Spicer has a hopeful outlook in dealing with the HIV outbreak.

“It’s a bad thing, but I also see that we can make some positive from it,” he said. “We can maybe get doors open to get some of the resources we need.”