Indiana County hit by HIV epidemic could end needle exchange
INDIANAPOLIS (AP) – A rural southern Indiana county that was the epicenter of the worst HIV epidemic ever caused by intravenous drug use in the state is set to end its exchange program syringes despite warnings that this could lead to an increased risk of disease.
Health officials, including the Centers for Disease Control and Prevention, have called Scott County program which started in 2015 success in drastically reducing the spread of infectious disease by providing IV users with clean syringes to discourage sharing of needles.
But the pursuit of such programs there and elsewhere have faced opponents who argue they allow drug abuse and lead to more needles being left in public places.
These arguments influenced Scott County Commissioner Randy Julian, who was elected in November for his first term on the three-member body, alongside Commissioners President Mike Jones, a longtime opponent of the exchange. They could vote Wednesday against the renewal of the program, which would lose its authorization in May 2022.
Julian said in an interview that six years after the HIV epidemic, drug addicts in the region are aware of the risks of sharing needles and that it is time for them to take responsibility for their actions.
“There is no end to the game,” Julian told The Associated Press. “He was introduced here and he did his job on what he should have done, but now is the time to move on and fight him in a different way and get people out of addiction instead. to give them needles. It’s not enough.
Scott County Needle Exchange started in 2015 after then-Gov. Mike Pence, amid the rise in user-driven HIV cases of a liquefied form of the painkiller Opana, overcame objections to such programs and authorized the state’s first-ever effort to provide drug addicts with needles clean.
The region’s HIV epidemic eventually reached around 235 infected people – including nearly 200 in Scott County, numbering 24,000 people, and centered in the small town of Austin, about 40 miles north of Louisville, Kentucky.
State Department of Health reports show Scott County recorded fewer than five new HIV cases in 2020 and its rate of hepatitis C infections has fallen by about two-thirds since 2015, although it remained the third highest among Indiana’s 92 counties in 2019.
Indiana State Health Commissioner Dr Kristina Box and her predecessor Dr Jerome Adams, who was US surgeon general under President Donald Trump, attended a meeting of county commissioners early of May to urge them to continue with the program. Box said dropping it would inevitably lead to an increase in HIV and hepatitis C cases.
“We might not see it immediately, but there is no doubt in my mind that we would see increasing rates of hepatitis C, we would see increasing rates of HIV, we would see people coming back to the emergency room,” said Box to reporters at the meeting.
Julian, the county commissioner, argued that the exchange program’s treatment referrals, tests and anti-overdose medications should remain available. Julian admitted that HIV cases could rise again if the exchange ends, but said if that happens, the program could be reinstated.
Indiana began allowing exchanges in 2015, but only with state approval, following the HIV epidemic in Scott County. State lawmakers in 2017 supported allowing counties and cities to create their own programs.
Indiana’s authorization for trade was slated to expire in 2022, but earlier this year lawmakers approved an extension of that authorization until July 2026.
Eight other counties now have needle programs, including Clark County just south of Scott County. Others are those with the cities of Indianapolis, Fort Wayne, Lafayette, Bloomington, Anderson, Richmond and Connersville.
Julian said the exchange did not end needle sharing after Scott County had more than 70 opioid overdoses last year, nearly two dozen of which were fatal. He said he was troubled by the items the program provides participants with syringes, including what he said were a tourniquet, a metal cooker, cotton balls and alcohol.
“It’s a little hard to swallow,” Julian said. “People here are tired of it. They are tired of exchanging needles.
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