The governor of Indiana, Mike Pence, has declared a public health emergency in parts of Indiana’s more rural counties. This health emergency comes as within the past few months, there have been over 79 cases of confirmed HIV, mostly in Scott County. Scott County is one of the most rural parts of Indiana, with only about 25,000 residents inhabiting the county, and it is about 30 minutes north of Louisville.
While you might not realize HIV is still really a serious medical issue that is infecting thousands of people annually, the biggest reason for HIV these days is drug use and abuse. That is the case with Indiana, as the heroin epidemic in Indiana, Kentucky, and Ohio, continues to increase at very quick rates. Indiana has been one of the Midwestern states that has seen the highest rise of heroin use, most of which the user is shooting up the drug, and reusing needles. Between shooting up heroin and continually reusing needles, the drug users are putting themselves and the community at a high risk of HIV. Indiana has also seen a jump in people abusing the painkiller Opana, which can be broken down and crushed to make it a drug that can be injected into the body. Opana is one of the only painkillers left on the market that has not been made from an anti-abuse chemical formula, which would make it impossible for drug users to inject.
In 2002, deaths related to the opioid painkillers was at 200 each year, but in 2012 that number was above 700 deaths a year. This is just one of the many lethal combinations that is gripping the small Indiana communities, but it’s affecting people from around the United States as well. In Scott County, there is one HIV testing clinic, but four other counties in Indiana also have just one HIV clinic. There is a lack of access to healthcare in these rural communities, which is one reason why HIV is beginning to rapidly spread throughout the county and nearby locations. A study from Trust for America’s Health in 2013 concluded that Indiana was last in getting federal funding per capita from the Centers for Disease Control. Indiana gets $13.72 per person for public healthcare, while other states were averaging about $19.54 per person. This lack of federal money has meant that healthcare clinics are far and few between, and the state is not getting any money that could be used for needle-exchange programs.
Injecting drugs also carries a risk of contracting Hepatitis-C, which has also seen a boom in rural communities like Scott County in Indiana. The U.S Department of Health and Human Services estimates that about one-quarter of all HIV-infected people also have Hepatitis-C.
Governor Pence issued the health emergency for Scott County, which is good because that means help and resources can now come to the area. There will now be a 30-day needle-exchange program starting in Scott County, which can help prevent further infections of HIV and Hepatitis-C. Drug users will continue to do the drugs, so making a needle-exchange program available is one way to protect them from themselves and to protect the community at the same time. The interesting part to this is that Pence is completely against needle-exchange programs, which could be why there is now a huge issue with HIV. Pence made a statement after signing the 30-day needle-exchange into effect that he felt this was the best move he could make at this time, he was taking the HIV outbreak very seriously, and that should be noted because he is so against the needle-exchange program.
HIV and Hepatitis-C also might not be diagnosed for months or years to come, so it’s hard to say how many people will end up infected before all is said and done. Pence is giving the needle-exchange program 30-days, but it might need to become a long-standing program in order to really impact the transmission and infection rates in the rural communities where healthcare is scarce and expensive.