Study Says Indiana’s HIV Outbreak Was Preventable

28 Jul Study Says Indiana’s HIV Outbreak Was Preventable


Photo: Steve Burns

The study says needle exchange programs play a key role in helping reduce the risk of an HIV outbreak.

A study published in the New England Journal of Medicine says Indiana’s HIV outbreak was preventable.

Health officials diagnosed more than 190 people with HIV since the outbreak started last year. Most of them live in Scott County and caught the virus from sharing needles they used to inject a powerful prescription pain killer called Opana.

Part of what made the outbreak so unique is it occurred in a small, rural community. And the study cautions it could happen elsewhere.

“The circumstances underlying this HIV outbreak are not unique to this community.”

—Study, New England Journal of Medicine

“The circumstances underlying this HIV outbreak are not unique to this community,” the study says.

It points to a lack of healthcare, substance abuse treatment and HIV testing as factors that contributed to the outbreak.

“We actually went down in our public health spending to $12.40 per capita, which is significantly lower than other states,” says Carrie Lawrence, a fellow at the Rural Center for AIDS/STD Prevention.

Before the number of HIV cases in Scott County skyrocketed, the study says there hadn’t been free HIV testing offered in the community since a Planned Parenthood location closed in 2013. Indiana State Health Commissioner Jerome Adams disputes that in a statement released Thursday.

“HIV testing has been available in Scott County since well before the outbreak and has never been limited to one facility,” Adams said in the statement. “The unfortunate reality is that research has shown repeatedly that people with substance use disorder often do not seek out medical care. All the testing facilities in the world won’t identify an outbreak if people don’t come in.”

HIV Contacts

Photo: New England Journal Of Medicine

This figure diagrams the network of 181 case patients in southeastern Indiana who received a new diagnosis of HIV infection between November 18, 2014, and November 1, 2015; the network is based on the syringe-sharing and sexual partners of the case patients at the time of their HIV diagnosis. The network comprises 536 unique persons and 1058 unique connections: 841 of the contacts in this network (79.5%) were syringe-sharing contacts, 81 (7.7%) were sexual contacts only, and 136 (12.8%) were syringe-sharing and sexual contacts.

The study also points to syringe exchange programs as a key component in preventing future outbreaks. It says such programs can reduce the risk of an HIV outbreak by as much as 56 percent.

Until last year, syringe exchange programs were illegal in the state. Legislators passed a bill that allows counties with high rates of Hepatitis C to declare a public health emergency and request state approval for a syringe exchange.

Representative Ed Clere, R-New Albany, authored the bill. He says it was a good compromise, but he wants to see more counties adopting exchanges.

“We have to move from viewing syringe exchange as something that we do in response to a crisis to viewing it as something we should be doing to prevent the next crisis,” he says.

Clere said his ideal bill would allow counties to start syringe exchanges without having to declare a public health emergency and would allow them to continue for more than a year.

Scott County became home to the first syringe exchange in the state following the outbreak. It’s one of five counties operating an exchange and more are in the process of requesting them.

You can read the full study below.

New England Journal Of Medicine Study

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