While the thought of an HIV epidemic causing a state of emergency might conjure up images of a poor sub-Saharan African state, the most recent epidemic is striking much closer to home. The state government of Indiana has declared a state emergency due to an unprecedented outbreak in Scott Country.

Indiana governor Mike Pence has declared a state of emergency and is moving to set up a needle exchange as the HIV is spreading rapidly due to drug use. Since December Scott County has diagnosed 79 different cases of HIV. Normally, the county only diagnoses five cases per year.

The drug is being spread mainly by the rapid use of Opana, a powerful semi-synthetic opiate. Heroin and other injected drugs are also believed to be playing a role. Scott County is known for being an economically depressed region, and is near Louisville, Kentucky, and also Cincinnati, Ohio. The proximity to these two major cities may help fuel the spread of the outbreak.

HIV Epidemic Ravages Indiana, Bringing 3rd World Problems In

State Back Tracking On Policy To Set-Up Needle Exchange

The state of Indiana is now suspending state laws in order to set up temporary needle-exchange programs. For now, the program will only be able to operate for 30 days, though the governor may renew the operating period. Indiana’s state government has generally opposed needle exchange programs and other programs that it believes condones drug abuse. With the rash of cases, however, the state government recognizes that it must move aggressively to contain the outbreak.

Needle exchange programs have been proven to help reduce the risk of needle-transmitted diseases. The programs work by allowing people to exchange used needles for clean needles, no questions asked, no ID required. In Indiana, to buy needles a person must provide an ID and sign a register. These onerous laws force many drug abusers underground, where they share and reuse needles. This helps to spread diseases, such as HIV.

Ultimately, states and average citizens will bear at least some of the burden in the form of increased health insurance premiums, and public funding for health care.

The outbreak in Indiana drives a painful lesson home. While developed countries often ignore 3rd world problems, such as Ebola, there is always a risk that they can strike closer to home. From a research perspective, HIV is well-studied in developed countries, probably due to the intense media attention the disease receives. When it comes to public health planning, however, it’s clear that we have a long way to go.