With an HIV outbreak tied to injection drug use currently underway in southeastern Indiana, Gov. Mike Pence announced that he will sanction a short-term needle exchange program.
Needle exchange has been used for HIV prevention for decades, but remains controversial. A form of harm reduction, needle exchange allows people to exchange used hypodermic needles for clean ones to reduce the risk of HIV transmission.
"What I'm thinking about carefully and thoughtful is what's needed in a public health emergency, what's necessary to really get control of this in the immediate future," Pence said in a press conference, according to USA Today.
The governor, a Republican, has called for a needle exchange program that would last only 30 days, leaving many wondering what will happen past April. Pence generally opposes needle exchange, but says he will make an exception after listening to public health officials.
Health officials have confirmed 72 cases of HIV in Southeastern Indiana and identified seven other preliminary positives that have yet to be confirmed. All of those infected are either Scott County residents or have ties to Scott County. The county normally sees an average of five HIV infections a year.
Aside from the needle exchange, the state has launched an awareness campaign that includes traditional and social media. State health Commissioner Jerome Adams, M.D., M.P.H., said the state will send a mobile unit to Scott County with resources to help curb the epidemic.
According to the Centers for Disease Control and Prevention (CDC), this particular case is indicative of a wider problem, which is injection drug use in rural areas and economically depressed regions, USA Today reports.
Blood is extremely effective at transmitting HIV, and opening needle exchanges could be an important public health strategy for HIV prevention in Indiana -- though some noted online that needle exchange should have been made available before the outbreak.
State epidemiologist Pam Pontones hopes to round up over 100 other people who may have been affected by the outbreak. "With the amount of drug use that's happening and the intravenous needle-sharing that's going on, if someone who's highly infectious becomes part of that sharing network, that infection can transmit very rapidly," Pontones said.
One person speaking out against Indiana's short-term program is Carrie Elizabeth Foote, professor of sociology at Indiana University. Foote, who is HIV positive and a former drug user, emphasized that while drug users can purchase clean needles without a prescription, they may be put off by the process. "One must sign a register when purchasing, which can deter folks," she said in a statement to Healthline.
However, Foote was even more worried about the lack of competency around HIV in Indiana and Indiana's HIV criminalization laws.
"The needle sharing/ sex laws are linked to nondisclosure, so it's only after people know their status that one could be potentially criminalized, so folks who do not know their status are not at risk," Foote said.
Mathew Rodriguez is the community editor for TheBody.com and TheBodyPRO.com. You can follow him on Twitter at @mathewrodriguez, like his Facebook page or visit him on his personal website.