Ten days ago, in Indiana Gov To Declare HIV Health Emergency In Scott County, we looked at a growing outbreak of IV drug-abuse related HIV in rural southern Indiana. With 72 cases reported over the past 3 months, their rate of infection was roughly 50 times higher than the state average.
Many local physicians were urging the establishment of a needle exchange program to slow the spread of the virus, but this is a public health initiative prohibited by state law.
At the time, the governor indicated he would consider putting aside that law in Scott County – at least temporarily – to address the crisis. Since the last report, at least a dozen additional cases have been identified.
This press release from the Indiana State Department of Health.
Start Date: 4/4/2015
AUSTIN—A needle exchange program in Scott County begins today. Governor Mike Pence authorized the measure as part of a comprehensive emergency executive order due to the recent HIV outbreak in southeastern Indiana. This temporarily suspends the Indiana Code on needle exchange within Scott County. State health officials today reported a total of 89 cases of HIV-related cases (84 confirmed and five preliminary positive cases).
Late last month, the Indiana State Department of Health and the Centers for Disease Control and Prevention (CDC) advised Governor Pence that the HIV outbreak in Scott County is an epidemic and based on that information, the Governor declared that a public health disaster emergency exists in Scott County. The Executive Order and needle exchange program expire April 25, but will be evaluated at the end of that period to determine if it should be continued.
The needle exchange will take place at the One-Stop Shop located at the Community Outreach Center, 2277 W. Frontage Road, Austin, Ind. Operated by the Scott County Health Department, the program will be open from 9 a.m. to 6 p.m. Monday through Saturday, and noon to 6 p.m. on Sunday. The Center will not be open on Easter Sunday (April 5). Grace Covenance Church has provided a free shuttle service to and from the One-Stop Shop from Austin by calling (317) 617-2223.
The needle exchange program includes Scott County residents only and participants will be asked to discuss their rate of drug use. The program will collect basic demographic information for research and statistical purposes.
"As State Health Commissioner and a physician, it is my hope that Scott County residents who need these services will take advantage of them and get the help they need and want,” said State Health Commissioner Jerome Adams, M.D., M.P.H.
Participating individuals will receive enough needles for one week. When in need of additional needles, participants are asked to bring their used needles to exchange. The needle exchange will also present an opportunity for health representatives to provide information about substance abuse treatment, as well as information on HIV/AIDS prevention and treatment.
“The goal is a clean syringe for each injection use,” said Brittany Combs, Scott County Public Health Nurse.
The State Health Department has established an incident command center in Scott County to expedite services and messages. Additionally, the One-Stop Shop is open to provide free HIV testing, vaccinations against tetanus, hepatitis A and B, and information about HIV and hepatitis prevention, treatment and resources. Substance abuse referrals are available and individuals can also get assistance in enrolling in Healthy Indiana Plan (HIP 2.0) insurance. The One-Stop Shop Info Line is (317) 605-1480.
Although not legal in every state, syringe exchange programs (SEPs) have been shown to be effective in the `reduction of harm’ among intravenous drug users, and by extension, the entire community.
Scott County reportedly suffers from high unemployment, a high dropout rate, skyrocketing teen pregnancy rates, and high drug use (see Chicago Tribune report), which means it will take more than a 3-week needle exchange program to address its problems.
But it’s a start.