The HIV Epidemic No One is Talking About

May 12th 2015

Ashley Nicole Black

Scott County, Indiana is suffering from an HIV epidemic and has been since December. Last week, according to the AP, there were 149 confirmed cases -- in a county of only 6,000 that usually has 5 cases a year.

To deal with this problem, the small town (population 4,200) at the center of the epidemic, Austin, is getting an HIV clinic that will provide free medical care, regardless of whether people have insurance or Medicaid.

What caused this epidemic?

The epidemic is the result of needle sharing by users of the liquidized prescription painkiller, Opana, the Times reports. At the end of March, Gov. Mike Pence (R) authorized a 30-day needle exchange program, despite there being a statewide ban of such programs. Pence reauthorized the program in April, and it will now run until May 24. The needle exchange program is controversial in Indiana because some opponents feel that the program might encourage drug use. Other feels that needle exchange programs don't do enough and that more education, drug treatment, and HIV treatments are needed instead of needle exchanges. Health officials, such as those at the White House Office of Drug Control Policy and the Centers for Disease Control and Prevention, support needle exchange programs as a good way to impede the spread of infection. ​

Eighty percent of the new HIV cases are related to Opana , and the CDC is contacting people who have shared needles with or had unprotected sex with anyone who has tested positive for HIV. (Most have had an average of nine partners. ) Researchers are discovering that many Opana users shoot up multiple times a day, often in family groups , using the same needle, which spreads infection quickly. Outbreaks happen quickly when there aren't local resources (healthcare, sexual and drug education, testing facilities, etc.) because poor people without access to transportation cannot utilize resources that are too far away. Many residents in the area lack transportation and health insurance, both of which may have helped prevent the epidemic and both of which will be major problems now that so many people in the region will need continued HIV treatment.

We should talk about Planned Parenthood and sex ed.

Compounding this outbreak is the fact that Scott County has been without a Planned Parenthood since 2013. Planned Parenthood does not only provide access to contraception, but also provides the important function of screening for sexually transmitted infection (STI) and HIV. Indiana has systematically attempted to make it difficult for women to access legal abortions, but in cutting down access to clinics that provided abortions, they have also made it difficult to access the low-cost health care that these clinics also provided.

A lack of education about HIV and addiction is also making the epidemic difficult to teat. There is also a great deal of misinformation in this rural area, according to an in-depth New York Times piece. Some are afraid to get treatment due to stigma. Others hold onto incorrect assumptions or prejudices about HIV and addiction -- that HIV is a "homosexual disease," or that needle exchanges enable addiction.

Now, due to a partnership between Austin's only doctor, Dr. William Cooke, and the AIDS Healthcare Foundation, the town will get a clinic. According to state health officials, there has been a drop in new cases over the past few weeks, prompting some to hope that the epidemic is ebbing.