Scott County was the lead story on national news broadcasts in early 2015. HIV infections were skyrocketing in the rural southern Indiana county, with the outbreak fueled by people using opioids who had started melting pills and injecting them with shared needles.
The town of Austin, population 4,100, had more than 22 HIV infections in a single week. Infections countywide – about 235 – exceeded the number of people infected through injection drug use in New York City in all of 2014.
The response was slow, but state and local health officials finally settled on a needle-exchange program that is credited with slowing the outbreak and hailed as a national model. This week, Scott County commissioners voted 2-1 to eliminate it, ignoring the pleas of State Health Commissioner Dr. Kristina Box and former U.S. Surgeon General Jerome Adams, who together attended a hearing to support the program.
“I know people that are alcoholics, and I don't buy 'em a bottle of whiskey,” said commissioners president Mike Jones. “So, I have a hard time handing a needle to somebody that I know they're going to hurt theirself with.”
Health officials fear the end of the program will fuel another HIV outbreak, as the demise of another exchange program did in Charleston, West Virginia.
“We hope we're wrong. But it's very, very likely – experts from all over the world tell us this is probably going to be another outbreak without a syringe service program,” county health administrator Michelle Matern said.