In the throes of the biggest HIV outbreak in Indiana history, officials in Scott County have known for years that drug use is at the heart of the crisis.
“This is just a result of some of the struggles that we’re going through here,” Scott County Sheriff Dan McClain said Wednesday, adding that his department will focus on stopping the flow of drugs from entering the county.
State and federal officials are taking action to stop the HIV outbreak — now called an epidemic — in its tracks.
Gov. Mike Pence is expected to sign an executive order today declaring a public health emergency in Scott County, where most of the outbreak is concentrated.
“This is not a Scott County problem. This is an Indiana problem,” Pence said after a meeting Wednesday at the Mid-America Science Park in Scottsburg with local and state officials.
The number of confirmed cases in southeastern Indiana has jumped from the previous 55 to 72, with seven preliminary cases yet to be confirmed. Every case of recent HIV infection is because of intravenous drug use — mostly from the prescription narcotic Opana.
But an overwhelming message local and state officials echoed Wednesday was that help is available.
“You are not alone in this problem,” Indiana State Health Commissioner Dr. Jerome Adams said. "You’re not alone in finding a solution to this problem because this is just a manifestation of mental health problems, addiction and our inability to diagnose and treat infectious diseases such as HIV, Hepatitis C and the like.
"And if we don’t get it solved down here in Scott County, it’s going to spread to the surrounding counties, it’s going to spread to the entire state.”
With every positive HIV test result, the pool of potential positives widens.
It’s an “expanding target,” Dr. Kevin Burke, Clark County public health officer, said.
Pam Pontones, Indiana state epidemiologist, said the health department is tracking 70 to 100 more contacts who could be potentially positive.
“We are hoping if we do the right things, right now, we will be able to disrupt the transmission of the disease so that we don’t have too many more positive cases,” Adams said.
Adams said that the state is also going to bring a mobile vital records unit to Scott County so that residents can obtain forms of identification to sign up for the Healthy Indiana Plan. It is also issuing an education campaign called “You are not alone.”
“HIV is not the death sentence that it once was,” Adams said. “It’s not even close. You can live 25, 30, 50 years if you get into treatment.”
McClain said he’s grateful for the temporary relief Pence’s executive order will bring — Scott County’s resources are exhausted.
“We have become the local rehab mental health and treatment center as well as the correction center here because of some of the resources we’ve lost over the years for those things,” McClain said.
But more permanent solutions could be possible through Indiana legislation.
Rep. Terry Goodin, D-Austin, said the Indiana General Assembly will discuss the possibility of expanding HIV testing to Scott and other rural counties, as well as drug rehabilitation facilities.
“Transportation is a huge issue for these folks,” Goodin said. “We know that. We know that they’d rather give $5 for their pill of Opana than they would to give $5 for gas to get somewhere to get a test.”
Beth Keeney, vice president of developments and grants for Clark County-based LifeSpring Health Systems, said the mental illness and substance abuse clinic has an outpatient facility in Scott County.
“Certainly we would encourage anyone who is addicted to any type of substance, whether they’re using needles to transmit that substance or not, to get treatment,” Keeney said. “Treatment works.”
Pence said his executive order will involve a “robust expansion” of resources to Scott County over the next 30 days in ensuring the virus does not spread. He said he met with Centers for Disease Control officials Monday, all confirming the outbreak has reached epidemic levels.
“Since that time, our administration has been evaluating options both with regard to resources and additional flexibility to permit health officials and law enforcement officials and all those agencies that are impacted by this epidemic to address it in a more effective way,” Pence said.
Details of the executive order will be available today, and Pence wouldn’t commit on a needle exchange program.
Local health officials and the CDC have endorsed the program, which would allow people to exchange their dirty needles for clean ones.
“I was listening very intently [during the meeting] and we heard diverse opinions in the room on that,” Pence said. “I will tell you that I do not support needle exchange as an anti-drug policy but this is a public health emergency, and I’m evaluating from all the issues and all the tools that may be available to local health officials in light of a public health emergency.”
But he did have a message for those who are at risk.
“To anyone [who can hear] the sound of my voice who is involved in intravenous drug use: Stop,” he said. “Your life is at stake. If you’re using drugs intravenously or if you’re using any drugs, get help. There is help, in this community and in communities all across the state of Indiana.”
Pence also urged drug users to get tested and to stop sharing dirty needles.
Burke, whose health department has tested Scott County residents for HIV, the virus which causes AIDS, said a needle exchange program is “absolutely” necessary in stopping the spread of the disease.
He said southeastern Indiana and Scott County need additional help with the growing epidemic.
“I think it's great that [Pence] came to the community to sort of measure the community’s concerns and listen to some of their ideas of how to help,” Burke said.
The News and Tribune in Jeffersonville/New Albany is part of CNHI, the Tribune-Star's parent company.