As HIV Outbreak Spreads North, State Officials Ponder Their Next Move

Apr 27, 2015

This sign in Scott County resident Tammy Breeding's yard responds to the recent HIV outbreak.
Credit Barbara Harrington / Indiana Public Broadcasting

The streets of Austin are lined with campaign signs focusing on the future of this struggling small town.

They’re on every corner, in every yard, even greeting drivers on the outskirts of town.

But, it’s the handwritten sign posted on Tammy Breeding’s lawn that sends perhaps the most powerful message of all.

"I had to make a statement. I want to take back my community, my neighborhood," she says.

The sign reads: "No loitering, prostituting in front of or around these premises. Violators will be prosecuted."

Breeding’s neighborhood is the epicenter of an HIV outbreak unlike anything the Centers for Disease Control has seen in rural America.

Health Department officials say people are spreading the disease primarily through intravenous drug use.

And, that’s a problem Austin’s been struggling with for years.

Breeding says you don’t have to walk far down North Church Street before you find someone looking to buy or sell drugs.

"The main drag what I call it is Church and Broadway. This is like a meeting corner for the drug deals, the prostitutes," Breeding says. "You can see it go from one house to another of where they’re going to get their next fix. And, they call them the shooting galleries because they go to get a shot then they get high." 

It’s gotten so bad, some neighbors are putting up barricades to prevent addicts and dealers from using their driveways as trade-off points.

And, Breeding says a temporary needle exchange program Governor Mike Pence authorized is only making the situation worse.

"I think if they continue this needle exchange, you’re going to have the worst epidemic with drugs coming in from all over that it’s not going to be able to be contained the way they want to contain it," she says.

The exchange is part of the state’s effort to curb the outbreak.

It’s setup in a Community Outreach Center in Austin and allows addicts to get enough clean needles for one week.

They give their first names and they get an ID card to join the program.

So far, Scott County Public Health Nurse Brittany Combs says participation has been lower than she hoped.

"We had to design the program from scratch," Combs says. "It takes a while to gain people’s trust. Especially this population – they’re not trusting. It takes a while for them to realize that they can trust us and partake in a program."

The governor’s executive order authorizes the program through May 25 and only in Scott County.

But, HIV is spreading.

Deputy State Health Commissioner Jennifer Walthall says there are now five cases in Jackson County – Scott County’s northern neighbor.

"I would like to add though the five cases that have been reported in Jackson County all of the contract tracing is complete so we feel that those five cases have been isolated and contained," Walthall says.

That’s a line some folks aren’t buying.

"For the governor to think that he can contain the epidemic in Scott County with an emergency order is reckless and will cost the lives of thousands of Hoosiers," says Scott County doctor Shane Avery.

He was one of several people who testified during a House committee hearing  this week asking legislators to make needle exchange programs legal in high-risk communities.

The bill would allow for local needle exchange programs in areas with the high rates of Hepatitis C, which is often an indicators of HIV.

Proponents like Co-Director of the Rural Center for AIDS and STD Prevention Beth Meyerson say the programs effectively quell outbreaks — but not if they’re limited.

"The nice thing today that I observed in the hearing is that there’s a great deal of interest and I think the legislators … they know it’s a bigger problem than Scott [County]," Meyerson says. "I don’t hear anyone making the statement that the state has been making which is only Scott and this is only the situation and when it’s all over it’s all over. It’s a lifetime need … and what about our own communities too?"

Executive Director of the Indiana Prosecuting Attorneys Council David Powell was the only person at the hearing to speak out against the needle exchange bill.

He says legislators need a more long-term solution to the outbreak that addresses funding and substance abuse treatment.

The proposed needle exchange bill wouldn’t provide any funding to help local communities establish exchanges.