Horrifying: HIV Outbreak In Indiana Grows

[orangeblossom]

It just keeps getting worse.  So so sad.


www.cnn.com/2015/04/24/health/hiv-indiana-spreads/index.html


(CNN)The number of new HIV infections in a rural Indiana county has grown, according to the Centers for Disease Control and Prevention. The institute is working with state health leaders to control the "severe outbreak," which has spread among users of a prescription opioid called Opana.



The outbreak has been ongoing since mid-December. As of Friday, 142 people have tested positive for HIV, with 136 confirmed cases and six more with preliminary positive test results, all in rural Scott and Jackson counties. This is a huge number of cases for an area that has a population of only a few thousand people.



The CDC and state health leaders held a news conference Friday to talk about the new numbers and about the growing threat of the spread of disease from IV drug use, especially in isolated rural areas that have sparse health resources.



Scott County, the epicenter of the outbreak, has only one doctor who deals with infectious disease, but the doctor is not an HIV specialist, the State Department of Health said. Since the rampant HIV outbreak was first noticed in mid-December, the state has tried to flood the area with additional resources. Indiana declared a public health emergency in that county in March.



Indiana University has sent health volunteers to provide a clinic, open once a week to help treat people and test them for HIV. These workers are also going door to door to try to educate the population about the danger of sharing needles.



So far, 33 patients have visited the temporary clinic, which is starting to see patients return to seek treatment.



It's no coincidence that many of the cases of the newly infected there are younger people "who weren't around in the '80s and '90s when HIV was at its peak," Dr. Jonathan Mermin said. In the 1980s, doctors were seeing an average of 35,000 new HIV infections among IV drug users, and that figure has been down 90% nationally, he said. So people aren't as aware about the danger of sharing needles.



Mermin is the director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Education will be key, he emphasized. Indiana Gov. Mike Pence also signed a 30-day executive order that allows for a needle exchange. It was set to expire Friday, but he extended the order another 30 days Tuesday. Needle exchanges have been scientifically shown to reduce new infections.



The state is also offering job services to people in the area. Dr. Joan Duwve, the chief medical consultant with the Indiana State Department of Health, spoke at length about how communities all along the Ohio River in her state and in Kentucky and West Virginia have seen a huge problem with prescription drug abuse, particularly in areas where there "is not a lot to do."



Many family members, across generations, live in the same house and will use the drugs together as "a community activity," Duwve said. And this has led to more needle sharing, which spreads infection. She said this has been a problem for these areas for at least a decade.



Another reason this infection has spread so rapidly is the nature of the drug itself. Opana, as the prescription opioid is known, needs to be injected more than once a day. Duwve said residents have reported injecting it four to 10 times a day to stay under its influence. When people start to feel the drug wear off after about four hours, they begin to feel sick and go into withdrawal. Often they'll turn to an injecting partner in the same house who will share their needle and their drug to give the person relief from these symptoms.



The other problem with this drug is that it requires a larger-gauge needle that exposes users to more blood, which increases the risk of infection.



Health leaders worry about the spread of HIV and other diseases such as hepatitis C around the country as the number of illegal prescription drug users has grown. There has been a 150% increase in hepatitis C between 2010 and 2013, the majority of the increase believed to be from injection drug abusers, the CDC said.



"The situation in Indiana should serve as a warning not to let our guard down," Mermin said. "This is a powerful reminder" that HIV and other infectious diseases "can gain ground at any time, unless you remain vigilant."

[stephm0188]

And that's just the people who have been tested.

[gpw]

Good GOD that is frightening. And so sad.

And like steph said, that's only the people who have been tested. There are probably lots of ostriches out there who haven't.

[darnkatz]

Terrifying.

[orangeblossom]

Apr 24, 2015 15:07:03 GMT -5 gpw said:

Good GOD that is frightening. And so sad.

And like steph said, that's only the people who have been tested. There are probably lots of ostriches out there who haven't.

Yup.  I mean look at the numbers who tested positive who even came back to the clinic, less than 25%

[bears]

Pence is allowing needle exchange temporarily in these counties--like for 30 days.

m.washingtonexaminer.com/pence-defends-needle-exchanges-to-combat-indiana-hiv-outbreak/article/2563563

[nursewife]

Wow. I haven't read about this till now. I live in a really small rural community as well. I can't imagine how awful this is for them. It would be absolutely devastating for that community.

[caramia]

Holy crap. I thought it was common knowledge that needle-sharing was a bad idea b/c of HIV/AIDS. I mean, obviously drug users don't make the best decisions, but the article says most of those infected are younger & weren't around in the 80s & 90s during peak AIDS years. I was born in 87...does that mean I'm old or just knowledgable about the dangers of needle-sharing? ?
It's so crazy, and scary, that this is a problem now. Hopefully they can slow the spread soon.

[secretlyevil]

ETA: I had utter reading comprehension fail.

[anonymous]

Apr 25, 2015 6:23:39 GMT -5 @mx said:

Apr 25, 2015 3:47:31 GMT -5 caramia said:

Holy crap. I thought it was common knowledge that needle-sharing was a bad idea b/c of HIV/AIDS. I mean, obviously drug users don't make the best decisions, but the article says most of those infected are younger & weren't around in the 80s & 90s during peak AIDS years. I was born in 87...does that mean I'm old or just knowledgable about the dangers of needle-sharing? ?
It's so crazy, and scary, that this is a problem now. Hopefully they can slow the spread soon.

They do know that it's dangerous. But addiction to heroin is pretty powerful so it's very difficult to say no when it's in front of you.

I used to volunteer with a really amazing harm reduction organization here in DC. Unfortunately they no longer exist because Congress wouldn't let our city government fund them and they couldn't raise enough in private donations to remain open. For some reason Americans HATE the idea of harm reduction even when the alternative is an epidemic of HIV and likely Hep C as well.

You would think things like needle exchange would be a unity horse. It is so short sighted of the national GOP to oppose needle exchanges but they do. I think it was just a few years ago where they held up the budget until funding for needle exchanges was removed. m.sfgate.com/bayarea/article/GOP-restores-ban-on-needle-exchange-funding-2424379.php

[Deleted]

Our lawmakers in Indiana can pat themselves on the back for contributing to this issue. That area had a Planned Parenthood a few years ago, but our wonderful GOP lawmakers made sure they defunded it so much that they couldn't stay open. It was the only facility offering services in the entire county. And now the stupid fucks are rushing to erect pop up clinics.

And there's still a major pushback from many in the area for supplying free needles because "omg, my taxes shouldn't pay for someone's needles!!" Its actually insane the number of people who have a problem with this. I'm two counties over and I feel like the attitude is "whatevs, that's what you get for doing drugs!" No one cares. It's enraging. I feel like this is an issue where the public needs to be educated and that's not happening.

[Deleted]

Apr 25, 2015 8:37:27 GMT -5 @mx said:

papiercherri have you asked those people how they feel about the state being on the hook for ARV treatment at ~40k/year for life for those infected? Because 90% of these people are going to end up on disability and Medicaid because of their infection. Or do they just prefer that the people infected not get consistent treatment and the state of Indiana become responsible for the creation of drug resistant strains of the virus

I actually have brought up the future healthcare costs of these patients, but all of Southwest Indiana isn't on my Facebook page.

I still think it would be nice if our local leaders and media took it upon themselves to be more proactive in spreading the facts about this situation.

[eclaires]

I got into an argument about southern Indiana a few months ago and this situation basically sums up everything I was trying to point out to a relative who lives in Bloomington.

It's a horrifying situation and unfortunately it seems like it's not going to get better any time soon.

[hoosierhealthcareae]

I keep watching it and waiting for anything to turn this mess around or any organization to come in and do something to take it all over. I had someone close to me work in the hospital in Jackson County for almost a decade and the clusterfuck that I watched happen time after time started out shocking and just became sad. Most of the county that knows better goes to neighboring county hospitals since the one there is run so poorly. Most department heads don't know how to budget. They buy equipment meant for much larger hospitals that literally sits idle for years. The locals call it a "glorified band-aid station" and go as far as possible for treatment. They doubled the size of the hospital and the expansion is basically empty. They can't keep an ER staff. They cut costs by cutting the entire night shift Pharmacy. The hospital is not doing well financially at all.

Jackson County has DARE and another substance abuse program, but they focus it mostly on alcohol. It's more of the don't buy your kids booze for basement parties and the good kids and families would never do drugs so why bother with the rest. The HS graduation rate is ok, but college grads that live there is low, and anything above that is single digits. One HS is a sports mill and those kids get scholarships and never look back. I can't count how many people asked me what the letters in my Master's stood for and I have a very well known one.

Scott County is the more organized of the two, but their Sheriff went on record last week saying that he was against needle exchanges because it would only encourage more drug usage and if they could just catch all the dealers the problem would be solved since the drugs would disappear or some BS like that. He went on to say he only went along with it since the healthcare people made him do it. Scott has so many dirty needles discarded that they are washing up in people's yards or parks when it rains. Reporters were getting them on camera and people are afraid to let their kids outside now. They caught 40 dealers last week, but there were still 5 out there.

Louisville's Metro Council has already passed a needle exchange ordinance (just the idea) last week that will take effect in late May to early June since they need a full on plan with the community. It passed unanimously based on 3 needle sticks happening to First Responders in 2014 and proximity to the outbreak. They are about 25-30 miles south of Scott County and 50 miles South of Jackson.

[5thofjuly]

I had a discussion about this in class last week. The students who were against the needle exchange program on the grounds that it would encourage drug use pretty much came around when a public health major asked, "OK, so if I handed you a clean needle right now, would you then start using heroin? Is the lack of a clean needle all that's standing between you and shooting drugs?"

[Deleted]

Some more statistics that may help people realize how big this problem is...

Austin, in Scott County, has a very small population, and currently 1 in 30 are known to be HIV positive.

There is also a list of hundreds of people that they have identified as at risk, of the ones that have been tracked down, 50% have tested positive. And they are still searching for a few hundred people.

Also, I believe the needle program has only been allowed in Scott County, the surrounding counties in Indiana are still NOT allowed to offer free needles.

And despite how it sounds, Scott County isn't exactly in the middle of nowhere. It's 25 minutes from a large metro area. So this epidemic has the potential to reach pretty far.